Compositions and methods for treating inflammation and fibrosis

ABSTRACT

The present invention features compositions featuring agents that bind to denatured collagen and methods of using such agents to treat or prevent fibrosis or inflammation in a subject.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims the benefit of U.S. Provisional Application Ser.No. 61/253,211, filed Oct. 20, 2009; the entire contents of which areincorporated herein by this reference.

STATEMENT OF RIGHTS TO INVENTIONS MADE UNDER FEDERALLY SPONSOREDRESEARCH

This work was supported by the following grant from the NationalInstitutes of Health, NIH/NCI Grant #2ROICA91645-08. The government hascertain rights in the invention.

BACKGROUND OF THE INVENTION

It has been estimated that nearly 45% of all deaths in the United Statesand developing countries are associate with fibroproliferative diseasesand inflammation. A wide range of human diseases and disorders areassociated with uncontrolled infiltration of inflammatory cells such asmonocytes, macrophages, neutrophils, and mast cells, which populatetissue sites of bacterial and viral infections, as well as sites oftissue damage caused by environmental toxins, chemicals, irradiation andmechanical trauma. Distinct inflammatory cell types, along with othercells such as activated fibroblasts, are well known to play criticalroles in many human pathologies. In large part due to the multifactorialnature of inflammation and fibrosis, progress has been slow in thedevelopment of less toxic and more efficacious treatments for this largegroup of highly debilitating and often lethal diseases. While drugs havebeen developed that target individual molecules such as inflammatorycytokines, growth factors, enzymes, and their cognate receptors, many ofthese anti-inflammatory compounds are only marginally effective due tothe diversity of molecules that contribute to these processes. Moreover,some of these anti-inflammatory drugs have side effects limiting theiruse.

Thus, there remains a need to develop safer and more efficaciousapproaches for the treatment of inflammation and fibrosis.

SUMMARY OF THE INVENTION

The present invention generally features compositions and methodsfeaturing agents that bind to denatured collagen (e.g., collagen typeI-IV) and methods of using such agents for the treatment or preventionof inflammation and/or fibrosis.

In one aspect, the invention provides a method of reducing fibrosis orinflammation in a subject (e.g., mammal, such as a human) in needthereof, the method involving administering to the subject atherapeutically effective amount of an agent that binds denaturedcollagen (e.g., any of types I-IV), wherein the agent is any one or moreof proteins, peptides, antibodies, aptamers, oligopeptides, and smallmolecule inhibitors. In one embodiment, the agent reduces theinfiltration of one or more types of inflammatory cells to a site insaid subject.

In another aspect, the invention provides a method of reducinginflammatory cell infiltration of a site in a subject in need thereof,the method involving administering to the subject a therapeuticallyeffective amount of an agent that binds denatured collagen type I-IV(e.g., denatured collagen type-IV), wherein the agent is any one or moreof proteins, peptides, antibodies, aptamers, oligopeptides and smallmolecule inhibitors.

In another aspect, the invention provides a method of preventing orreducing ultraviolet radiation damage, ionizing radiation damage, orchemotherapy damage to a cell, tissue, or organ, the method involvingadministering to the subject a therapeutically effective amount of anagent that binds denatured collagen type I-IV (e.g., denatured collagentype-IV), wherein the agent is any one or more of proteins, peptides,antibodies, aptamers, oligopeptides and small molecule inhibitors.

In another aspect, the invention provides a kit for use in reducinginflammatory cell infiltration into a site comprising an agent thatbinds denatured collagen type I-IV (e.g., denatured collagen type-IV),and instructions for use.

In another aspect, the invention provides a kit for use in treating orpreventing fibrosis or inflammation in a subject, the kit comprising anagent that binds denatured collagen type I-IV (e.g., denatured collagentype-IV), and instructions for use.

In various embodiments of any of the above aspects, the site is not atumor site or other neoplastic tissue. In still other embodiments of theabove aspects, the inflammatory cell is any one or more of monocytes,macrophages, neutrophils and mast cells. In still other embodiments ofthe above aspects, the agent reduces inflammatory cell infiltration to asite. In still other embodiments of the above aspects, the agent reducesadhesion to extracellular matrix or basement membrane. In still otherembodiments of the above aspects, the agent reduces fibroblast celladhesion to denatured collagen type I-IV. In still other embodiments ofthe above aspects, the agent is administered prior to, concurrent with,or subsequent to UVA radiation or ionizing radiation exposure or priorto chemotherapy. In still other embodiments of the above aspects, thesite is the site of a bio-implant. In still other embodiments of theabove aspects, the agent is an antibody or a monoclonal antibody, suchas a humanized antibody. In still other embodiments of the aboveaspects, the agent specifically binds to an epitope of denaturedcollagen (e.g., collagen types I-IV). In still other embodiments of theabove aspects, the agent specifically binds to an epitope ofanti-denatured collagen type-IV comprising GLGP, GLGPGP, orOGAKGLPGPOGPOGPY. In still other embodiments of the above aspects, theagent is any one or more of L-K-Q-N-G-G-N-F-S-L, L-G,S-L-K-Q-N-G-G-N-F-S-L, C-L-K-Q-N-G-G-N-F-S-L-G, S-L-K-Q-N-G-G-N-F-S-L-Cand K-G-G-C-L-K-Q-N-G-G-N-F-S-L-G-G-K. In still other embodiments of theabove aspects, the subject has a condition selected from the groupconsisting of pulmonary fibrosis, liver fibrosis, and kidney fibrosis.In still other embodiments of the above aspects, the inflammation isassociated with a tissue selected from the group consisting ofpulmonary, liver, brain or kidney tissue. In still other embodiments ofthe above aspects, the inflammation and/or fibrosis is associated with acondition selected from the group consisting of arthritis,arthrosclerosis, scleroderma, sarcoidosis, psoriasis, inflammatory eyediseases, ischemic and inflammatory cardiovascular diseases, andischemic and inflammatory bowel diseases.

Compositions and articles defined by the invention were isolated orotherwise manufactured in connection with the examples provided below.Other features and advantages of the invention will be apparent from thedetailed description, and from the claims.

DEFINITIONS

Unless defined otherwise, all technical and scientific terms used hereinhave the meaning commonly understood by a person skilled in the art towhich this invention belongs. The following references provide one ofskill with a general definition of many of the terms used in thisinvention: Singleton et al., Dictionary of Microbiology and MolecularBiology (2nd ed. 1994); The Cambridge Dictionary of Science andTechnology (Walker ed., 1988); The Glossary of Genetics, 5th Ed., R.Rieger et al. (eds.), Springer Verlag (1991); and Hale & Marham, TheHarper Collins Dictionary of Biology (1991). As used herein, thefollowing terms have the meanings ascribed to them below, unlessspecified otherwise.

When the terms “one,” “a,” or “an’ are used in this disclosure, theymean “at least one” or “one or more,” unless otherwise indicated.

By “agent” is meant any small molecule chemical compound, antibody,nucleic acid molecule, or polypeptide, or fragments thereof.

By “ameliorate” is meant decrease, suppress, attenuate, diminish,arrest, or stabilize the development or progression of a disease.

By “antibody” is meant any immunoglobulin polypeptide, or fragmentthereof, having immunogen binding ability. As used herein, the term“antibodies” includes polyclonal antibodies, affinity-purifiedpolyclonal antibodies, monoclonal antibodies, and antigen-bindingfragments, such as F(ab′)₂ and Fab proteolytic fragments. Geneticallyengineered intact antibodies or fragments, such as chimeric antibodies,Fv fragments, single chain antibodies, and the like, as well assynthetic antigen-binding peptides and polypeptides, are also included.Non-human antibodies may be humanized by grafting non-human CDRs ontohuman framework and constant regions, or by incorporating the entirenon-human variable domains. In certain preferred embodiments, humanizedantibodies may retain non-human residues within the human variableregion framework domains to enhance proper binding characteristics.

As used herein, “antagonist’ is meant to refer to a compound thatinhibits a naturally occurring biological activity.

By “binds” is meant having a physicochemical affinity for that molecule.Binding may be measured by any of the methods of the invention.

In this disclosure, “comprises,” “comprising,” “containing” and “having”and the like can have the meaning ascribed to them in U.S. patent lawand can mean “includes,” “including,” and the like; “consistingessentially of” or “consists essentially” likewise has the meaningascribed in U.S. patent law and the term is open-ended, allowing for thepresence of more than that which is recited so long as basic or novelcharacteristics of that which is recited is not changed by the presenceof more than that which is recited, but excludes prior art embodiments.

As used herein, a “cryptic epitope” within a collagen is meant to referto a sequence that is not exposed for recognition within a nativecollagen, but is capable of being recognized by an agent that bindsdenatured collagen. Peptide sequences that are not solvent exposed orare only partially solvent exposed in the native structure are potentialcryptic epitopes. The sequence of cryptic epitopes can be identified bydetermining the specificity of an antagonist. Candidate cryptic epitopesalso can be identified, for example, by examining the three dimensionalstructure of a native triple helical collagen.

As used herein “native collagen” is meant to refer to a collagenmolecule that is predominately in its triple helical form. Exemplarycollagens include but are not limited to collagen types I-IV.

As used herein “denatured collagen” is meant to refer to a collagen thatis no longer predominantly in its native triple helical form. Thedenatured collagen can be denatured full-length collagen or a fragmentof collagen. A fragment of collagen can be any collagen sequence shorterthan a full length collagen sequence. The term “denatured collagen”encompasses “proteolyzed collagen”. “Proteolyzed collagen” refers to acollagen that has been structurally altered through the action of aproteolytic enzyme.

“Detect” refers to identifying the presence, absence or amount of theobject to be detected.

By “effective amount” is meant the amount of a required to amelioratethe symptoms of a disease relative to an untreated patient. Theeffective amount of active compound(s) used to practice the presentinvention for therapeutic treatment of a disease varies depending uponthe manner of administration, the age, body weight, and general healthof the subject. Ultimately, the attending physician or veterinarian willdecide the appropriate amount and dosage regimen. Such amount isreferred to as an “effective” amount.

As used herein, an “epitope” is meant to refer to a region of a proteinto which an antibody can bind. An epitope can be a linear peptidesequence or can be composed of noncontiguous amino acid sequences. Anantagonist can recognize one or more sequences; therefore, an epitopecan define more than one distinct amino acid sequence target. Theepitopes recognized by an antagonist can be determined by peptidemapping and sequence analysis techniques well known to one of skill inthe art.

By “fragment” is meant a portion of a polypeptide or nucleic acidmolecule. This portion contains, preferably, at least 10%, 20%, 30%,40%, 50%, 60%, 70%, 80%, or 90% of the entire length of the referencenucleic acid molecule or polypeptide. A fragment may contain 3, 5, 10,20, 30, 40, 50, 60, 70, 80, 90, or 100, 200, 300, 400, 500, 600, 700,800, 900, or 1000 nucleotides or amino acids.

The term “peptide” as used herein is meant to refer to a series of twoor more covalently linked amino acids. A linear, cyclic, or branchedpeptide can be used in practicing the invention.

The phrase “pharmaceutically acceptable” refers to molecular entitiesand compositions that are “generally regarded as safe”, e.g., that arephysiologically tolerable and do not typically produce an allergic orsimilar untoward reaction, such as gastric upset, dizziness and thelike, when administered to a human. Preferably, as used herein, the term“pharmaceutically acceptable” means approved by a regulatory agency ofthe Federal or a state government or listed in the U.S. Pharmacopeia orother generally recognized pharmacopeia for use in animals, and moreparticularly in humans. The term “carrier” refers to a diluent,adjuvant, excipient, or vehicle with which the compound is administered.Such pharmaceutical carriers can be sterile liquids, such as water andoils, including those of petroleum, animal, vegetable or syntheticorigin, such as peanut oil, soybean oil, mineral oil, sesame oil and thelike. Water or aqueous solution saline solutions and aqueous dextroseand glycerol solutions are preferably employed as carriers, particularlyfor injectable solutions. Suitable pharmaceutical carriers are describedin “Remington's Pharmaceutical Sciences” by E. W. Martin.

By “isolated polynucleotide” is meant a nucleic acid (e.g., a DNA) thatis free of the genes which, in the naturally-occurring genome of theorganism from which the nucleic acid molecule of the invention isderived, flank the gene. The term therefore includes, for example, arecombinant DNA that is incorporated into a vector; into an autonomouslyreplicating plasmid or virus; or into the genomic DNA of a prokaryote oreukaryote; or that exists as a separate molecule (for example, a cDNA ora genomic or cDNA fragment produced by PCR or restriction endonucleasedigestion) independent of other sequences. In addition, the termincludes an RNA molecule that is transcribed from a DNA molecule, aswell as a recombinant DNA that is part of a hybrid gene encodingadditional polypeptide sequence.

By an “isolated polypeptide” is meant a polypeptide of the inventionthat has been separated from components that naturally accompany it.Typically, the polypeptide is isolated when it is at least 60%, byweight, free from the proteins and naturally-occurring organic moleculeswith which it is naturally associated. Preferably, the preparation is atleast 75%, more preferably at least 90%, and most preferably at least99%, by weight, a polypeptide of the invention. An isolated polypeptideof the invention may be obtained, for example, by extraction from anatural source, by expression of a recombinant nucleic acid encodingsuch a polypeptide; or by chemically synthesizing the protein. Puritycan be measured by any appropriate method, for example, columnchromatography, polyacrylamide gel electrophoresis, or by HPLC analysis.

As used herein, “obtaining” as in “obtaining an agent” includessynthesizing, purchasing, or otherwise acquiring the agent.

By “proliferative disease” is meant a disease that is caused by orresults in inappropriately high levels of cell division, inappropriatelylow levels of apoptosis, or both. For example, cancer is an example of aproliferative disease. Examples of cancers include, without limitation,leukemias (e.g., acute leukemia, acute lymphocytic leukemia, acutemyelocytic leukemia, acute myeloblastic leukemia, acute promyelocyticleukemia, acute myelomonocytic leukemia, acute monocytic leukemia, acuteerythroleukemia, chronic leukemia, chronic myelocytic leukemia, chroniclymphocytic leukemia), polycythemia vera, lymphoma (Hodgkin's disease,non-Hodgkin's disease), Waldenstrom's macroglobulinemia, heavy chaindisease, and solid tumors such as sarcomas and carcinomas (e.g.,fibrosarcoma, myxosarcoma, liposarcoma, chondrosarcoma, osteogenicsarcoma, chordoma, angiosarcoma, endotheliosarcoma, lymphangiosarcoma,lymphangioendotheliosarcoma, synovioma, mesothelioma, Ewing's tumor,leiomyosarcoma, rhabdomyosarcoma, colon carcinoma, pancreatic cancer,breast cancer, ovarian cancer, prostate cancer, squamous cell carcinoma,basal cell carcinoma, adenocarcinoma, sweat gland carcinoma, sebaceousgland carcinoma, papillary carcinoma, papillary adenocarcinomas,cystadenocarcinoma, medullary carcinoma, bronchogenic carcinoma, renalcell carcinoma, hepatoma, nile duct carcinoma, choriocarcinoma,seminoma, embryonal carcinoma, Wilm's tumor, cervical cancer, uterinecancer, testicular cancer, lung carcinoma, small cell lung carcinoma,bladder carcinoma, epithelial carcinoma, glioma, astrocytoma,medulloblastoma, craniopharyngioma, ependymoma, pinealoma,hemangioblastoma, acoustic neuroma, oligodenroglioma, schwannoma,meningioma, melanoma, neuroblastoma, and retinoblastoma).

By “reference” is meant a standard or control condition.

A “reference sequence” is a defined sequence used as a basis forsequence comparison. A reference sequence may be a subset of or theentirety of a specified sequence; for example, a segment of afull-length cDNA or gene sequence, or the complete cDNA or genesequence. For polypeptides, the length of the reference polypeptidesequence will generally be at least about 16 amino acids, preferably atleast about 20 amino acids, more preferably at least about 25 aminoacids, and even more preferably about 35 amino acids, about 50 aminoacids, or about 100 amino acids. For nucleic acids, the length of thereference nucleic acid sequence will generally be at least about 50nucleotides, preferably at least about 60 nucleotides, more preferablyat least about 75 nucleotides, and even more preferably about 100nucleotides or about 300 nucleotides or any integer thereabout ortherebetween.

By “specifically binds” is meant a compound or antibody that recognizesand binds a polypeptide of the invention, but which does notsubstantially recognize and bind other molecules in a sample, forexample, a biological sample, which naturally includes a polypeptide ofthe invention.

By “subject” is meant a mammal, including, but not limited to, a humanor non-human mammal, such as a bovine, equine, canine, ovine, rodent, orfeline.

The terms “treat” and “treatment” are meant to refer to therapeutic orprophylactic interventions that favorably alter a pathological state.Treatments include procedures that moderate or reverse the progressionof, reduce the severity of, prevent, or cure a disease. In addition,“treat”, “treating”, and “treatment” can also mean prolonging survivalas compared to expected survival if not receiving treatment.

Unless specifically stated or obvious from context, as used herein, theterm “about” is understood as within a range of normal tolerance in theart, for example within 2 standard deviations of the mean. About can beunderstood as within 10%, 9%, 8%, 7%, 6%, 5%, 4%, 3%, 2%, 1%, 0.5%,0.1%, 0.05%, or 0.01% of the stated value. Unless otherwise clear fromcontext, all numerical values provided herein are modified by the termabout.

The recitation of a listing of chemical groups in any definition of avariable herein includes definitions of that variable as any singlegroup or combination of listed groups. The recitation of an embodimentfor a variable or aspect herein includes that embodiment as any singleembodiment or in combination with any other embodiments or portionsthereof.

Any compositions or methods provided herein can be combined with one ormore of any of the other compositions and methods provided herein.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A-1C show that the Clk-peptide reduced inflammation. FIG. 1A (Topleft) shows that untreated CAM tissues exhibited minimal if any tissuethickening surrounding the central filter disc. In contrast, bFGF(FGF-2) potently induced a strong inflammatory response (Top right) asindicated by the robust thickening of CAM, which begins to overlap andpartially cover the central area of the filter disc (Arrows). Similarresults were noted under control peptide treated conditions (Bottomleft). Importantly, treatment with CLK-peptide (250 ug/day) dramaticallyreduced the overall levels of inflammation (Bottom right) as compared toeither bFGF-2 alone (Top right) or control peptide (Bottom left). Tofurther examine the CM tissues, frozen sections of similar treated CAMtissues were stained by H&E (FIG. 1B). As shown in FIG. 1B (Top left),few eosinophillic infiltrates were observed in the untreated CAM tissues(Arrow). In contrast, FGF-2 potently induced a strong inflammatoryresponse (Top right) as indicated by the robust infiltration of theeosinophillic (Pink) infiltrates (Arrows). Importantly, treatment withCLK-peptide dramatically reduced the overall levels of inflammatoryinfiltrates (Bottom left) as compared to either bFGF-2 alone (Top right)or control peptide (Bottom right). FIGS. 1C and 1D are graphs thatquantify the effect of the CLK-peptide on inflammation.

FIG. 2 includes two micrographs that show murine macrophage attachmentto the CLK/HU177 cryptic collagen epitope. Culture plates were coatedwith either (A) denatured (den) collagen-IV or (B) the CLK/HUI77 crypticepitope (16-mer OGAKGLPGPOGPOGPY SEQ ID NO: 1, where O representshydroxylated prolines. Isolated primary murine peritoneal macrophages(1×10⁵) were seeded on the coated wells in adhesion buffer and allowedto attach for 45 minutes. Photos were taken at a magnification of 200×.

FIGS. 3A-3C are photomicrographs showing that the CLK-peptide inhibitsmacrophage attachment to the CLK/HU177 cryptic collagen epitope. Cultureplates were coated with the CLK/HUI77 cryptic epitope(OGAKGLPGPOGPOGPY), where O represents hydroxylated prolines.Macrophages (1×10⁵) were seed on the coated wells in the presence (100μg/ml) or absence of CLK or control peptide and allowed to attach.Photos were taken at a magnification of 100×.

FIG. 4 is a graph showing that elevated levels of collagen type-I weredetected in conditioned medium from fibroblasts attached to denaturedcollagen type-IV as compared to native collagen type-IV.

FIG. 5 is a graph showing that the CLK-peptide inhibited fibroblast celladhesion to denatured collagen. Culture plates were coated withdenatured collagen-IV (10 ug/ml). Rat fibroblasts were resuspended inthe presence (250 μg/ml) or absence of CLK peptide (LKQNGGNFSL) orcontrol peptide (RYNEVKKKM). Cells were allowed to attach for 30 minutesand stained with crystal violet. Data bars represent the mean OD+/−S.D.derived from eluted cell associated crystal violet.

FIG. 6 is a graph showing that fibroblasts readily attached toimmobilized denatured collagen. In contrast, fibroblast adhesion wasdramatically inhibited in the presence of the CLK-peptide while thecontrol peptide had little, if any, effect.

DETAILED DESCRIPTION OF THE INVENTION

The invention provide compositions and methods for the prevention ortreatment of inflammation and fibrosis using agents that inhibit bindingto a non-cellular cryptic collagen epitope.

The invention is based, at least in part, on the discovery that agentsthat inhibit binding to a non-cellular cryptic collagen epitopephysically and selectively prevent or reduce infiltration of many of thediverse cell types known to contribute to inflammation and fibrosis. Inparticular, as reported in more detail below, a peptide that targeted acryptic collagen epitope inhibited infiltration of inflammatory cells invivo. In addition, the CLK-peptide inhibited normal macrophage andfibroblast adhesion to denatured collagen. Accordingly, the inventionprovides agents that disrupt binding to a non-cellular cryptic collagenepitope recognized by the CLK-peptide, and the use of such agents forthe treatment and/or prevention of conditions associated withinflammation and fibrosis. Advantageously, agents that bind to thecryptic collagen epitope simultaneously inhibit infiltration andlocalization of a variety of different cell types, each of which mayproduce and secrete many known pro-inflammatory molecules, rather thaninhibiting the functional activity of one specific factor. Compositionsand methods of the invention have significant therapeutic benefits overconventional anti-inflammatories, because the present compositions andmethods limit local tissue access to numerous cell types and moleculesrequired for fibrosis and inflammation. In addition, compositions andmethods of the invention are unlikely to produce the adverse effectsassociated with many conventional anti-inflammatories because theytarget a highly selective epitope that is restricted to sites of tissuedamage rather than a target that is broadly distributed, thus likelyreducing the possibility of side effects. The compositions of theinvention are particularly useful in treating a variety of diseases anddisorders associated with angiogenesis and fibrosis, by potentiallysimultaneously inhibiting infiltration and localization of a variety ofdifferent cell types, each of which may produce and secrete many knownpro-inflammatory molecules.

Collagen

Collagen is an extracellular matrix protein containing a[Gly-Xaa-Xaal]_(r), sequence motif. Collagen is a fibrous multi-chaintriple helical protein that exists in numerous forms. At least 18genetically distinct types of collagen have been identified, many ofwhich have distinct tissue distributions and functions. The maturecollagen molecule is composed of two al chains and one α2 chain twistedinto a triple helix. Collagens type-I and type-IV, for example, arecomposed of major chains designated α1(I) and α2(I) and α1(IV) andα2(IV), respectively. In vivo, collagen is normally found in the maturetriple helical form. Generally, a collagen is an extracellular matrixprotein containing a [Gly-Xaa-Xaa]_(n) sequence. Collagen types are wellknown in the art (see, e.g., Olsen, B. R. (1995) Curr. Op. Cell. Biol.5:720-727; Kucharz, E. J. The Collagens: Biochemistry andPathophysiology. Springer-Verlag, Berlin, 1992; Kunn, K. in Structureand Function of Collagen Types, eds: R. Mayne and R. E. Burgeson,Academic Press, Orlando). Human collagens are preferred collagens.

Denatured collagen refers to collagen that no longer predominantlyassumes the native triple helical form. Denaturation of a collagen canbe monitored, for example, by spectroscopic changes in opticalproperties such as absorbance, circular dichroism or fluorescence of theprotein, by nuclear magnetic resonance, by Raman spectroscopy, or by anyother suitable technique. Denatured collagen refers to denatured fulllength collagen, as well as to fragments of collagen. A fragment ofcollagen can be any collagen sequence shorter than a native collagensequence. For fragments of collagen with substantial native structure,denaturation can be effected as for a native full-length collagen.Fragments also can be of a size such that they do not possesssignificant native structure or possess regions without significantnative structure of the native triple helical form. Such fragments aredenatured all or in part without requiring the use of heat or of achaotropic agent. The term denatured collagen encompasses proteolyzedcollagen. Proteolyzed collagen refers to a collagen that has beenfragmented through the action of a proteolytic enzyme. In particular,proteolyzed collagen can be prepared by treating the collagen with ametalloproteinase, such as MMP-1, MMP-2 or MMP-9, or by treating thecollagen with a cellular extract containing collagen degrading activity.

Denatured Collagen

In vivo, changes in the structure of collagen are associated withUV-damage and other insults. As reported in more detail below, denaturedcollagen and/or fragments thereof likely facilitate inflammatory cellinfiltration of sites of cellular damage. Agents that physically and/orselectively bind to denatured collage, particularly a cryptic epitope ofcollagen type I-IV, thereby blocking the binding of inflammatory cells,are useful for inhibiting inflammatory cell infiltration. Such agentsare termed “antagonists” of denatured collagen. As used herein, a“cryptic epitope” within a collagen refers to a sequence that is notexposed for recognition within a native collagen, but that is capable ofbeing recognized by an antagonist of a denatured collagen. Suchantagonists physically and selectively bind to the denatured collagenand reduce or block the biological function of the denatured collagen.In particular, an agent that physically or selectively binds to acryptic epitope within collagen reduces cell (e.g., fibroblast,macrophage) binding to the denatured collagen. Peptide sequences thatare not solvent exposed or are only partially solvent exposed in thenative structure are potential cryptic epitopes. The sequence of crypticepitopes can be identified by determining the specificity of anantagonist. Candidate cryptic epitopes also can be identified, forexample, by examining the three dimensional structure of a native triplehelical collagen.

An epitope is an amino acid sequence or sequences that is recognized byan agent of the invention (e.g., an antibody). An epitope can be alinear peptide sequence or can be composed of noncontiguous amino acidsequences. An agent can recognize one or more sequences, therefore anepitope can define more than one distinct amino acid sequence target. Anepitope recognized by an agent of the invention can be determined bypeptide mapping and sequence analysis techniques well known to one ofskill in the art.

In one embodiment, an agent of the invention selectively binds to adenatured collagen. The agent may bind to native collagen, but the agentbinds with substantially reduced affinity to the native form of thecollagen. A “substantially reduced affinity” is an affinity of about3-fold lower than that for the denatured collagen, more preferably about5-fold lower, and even more preferably about 10-fold lower, and evenmore preferably greater than 10-fold lower. Likewise, “substantiallyless” indicates a difference of at least about a 3-fold difference whenreferring to relative affinities. Antagonists may be specific for anyone of the denatured collagens. In one embodiment, an agent of theinvention binds specifically to denatured collagen type I-IV.

In another embodiment, the agent is a protein, peptide, antibody,aptamer, oligopeptide or small molecule inhibitor, or a fragment of oneof these. In one preferred embodiment, the agent is an antibody. Inanother embodiment, the agent is the CLK/HUI77 cryptic epitopeOGAKGLPGPOGPOGPY.

In certain preferred embodiments, the agent reduces the infiltration ofone or more types of inflammatory cells. In other preferred embodiments,the agent reduces macrophage adhesion or reduces fibroblast celladhesion to denatured collagen type-IV. Methods for assaying adhesionare described in the Examples. In still other embodiments, cell adhesionis measured using radioactivity, staining methods (e.g., staining cellswith a dye, such as crystal violet), or with a fluorescent probe. USApplication No. 20040242490, incorporated by reference in its entiretyherein, describes denatured collagen type-IV selective antagonists.

In one embodiment, an agent of the present invention has the amino acidcore sequence L-K-Q-N-G-G-N-F-S-L. One preferred agent for use in thepresent invention is the CLK-peptide. A CLK-peptide binds to denaturedcollagen type-IV with high specificity. The amino acid sequence of CLKpeptide is C-L-K-Q-N-G-G-N-F-S-L-G. The CLK-peptide binds to regionswithin denatured collagen type-IV and inhibits cellular interactionswith denatured collagen type-IV.

Another preferred selective denatured collagen type-IV antagonist foruse in the present invention is SLK-peptide. SLK-peptide binds with highspecificity to denatured collagen type-IV and inhibits cellularinteractions with denatured collagen type-IV. The amino acid sequence ofSLK-peptide is S-L-K-Q-N-G-G-N-F-S-L-C.

A further preferred selective denatured collagen type-IV antagonist foruse in the present invention is KGGCLK peptide. KGGCLK peptide bindswith high specificity to denatured collagen type-IV and inhibitscellular interactions with denatured collagen type-IV. The amino acidsequence of KGGCLK peptide is -K-G-G-C-L-K-Q-N-G-G-N-F-S-L-G-G-K.

Agents that bind to denatured collagen can be identified using anymethod known in the art. In one embodiment, sequential solid phasebinding assays, for example, are used to identify denatured collagentype-IV selective antagonists. Preferred methods for identifyingdenatured collagen type-IV antagonists are subtractive immunization (Xu,J. et al. (2000) Hybridoma, Vol. 19:375-385) and subtractive phagedisplay (Amstutz P., et al. (2001) Curr. Opin. Biotechnol., vol.12:400-405).

Denatured collagen is produced using any method known in the art. Apreferred method of denaturation is thermal denaturation because thermaldenaturation results in fewer small fragments that may have littleimmunogenicity in vivo. Collagen type-IV can be thermally denatured by,for example, heating collagen type-IV to 100° C. for fifteen minutes.Denaturation can also be accomplished by treating the collagen with achaotropic agent. Suitable chaotropic agents include, for example,guanidinium salts. Collagen can also be denatured by ionizing radiation,non-ionizing radiation (ultraviolet), thermal injury, and mechanicalstress or force. Collagen can be denatured by proteolysis. Inparticular, proteolyzed collagen can be prepared by treating thecollagen with a metalloproteinase, such as MMP-1, MMP-2 or MMP-9, or bytreating the collagen with a cellular extract containing collagendegrading activity. Proteolyzed collagen may also occur naturally atsites of neovascularization, tumor growth, metastasis, bacterialinvasion, arthritis and inflammation in a tissue.

Denaturation of a collagen can be monitored, for example, byspectroscopic changes in optical properties such as absorbance, circulardichroism or fluorescence of the protein, by nuclear magnetic resonance,by Raman spectroscopy, or by any other suitable technique.

The resultant denatured collagen type-IV fragments can then be fixed toa solid matrix. Peptides known to bind collagen can be obtained from apeptide library. (Amstutz P., et al. (2001) Curr. Opin. Biotechnol.,vol. 12:400-405). The collagen-binding peptides can be passed over thesolid matrix. Peptides that bind denatured collagen type-IV adhere tothe solid matrix. The adherent peptides can then be washed from thesolid matrix and then passed over a second solid matrix to which nativecollagen type-IV is fixed. Peptides that do not bind to the second solidmatrix are denatured collagen type-IV selective antagonists.

Agents that selectively bind to denatured collagen can be generatedusing several different techniques that are well known to those skilledin the art. In one embodiment, a two hybrid system (e.g., Fields, S.(1989) Nature 340:245-6) uses a collagen fragment as “bait” forselecting protein antagonists from a library that binds to the collagenpeptide. This system and its operation are described in Green, D. M., etal., Proc. Natl. Acad. Sci. USA. 100:1010-1015 (2003) and in Gyuris, J.et al. (1993) Cell, Vol. 75: 791-803. The library of potentialantagonists can be derived from a cDNA library, for example. In anotherembodiment, the potential antagonists can be variants of known collagenbinding proteins, such as integrins and fibronectin. (Hynes, R. O.(1992) Cell, Vol. 69:11-25; Steffensen, B., et al. (2002) Matrix Biol.,Vol. 21:399-414; Ingham, K. C., et al. (2002) Arch. Biochem. Biophys.,Vol. 407:217-223). Such proteins can be randomly mutagenized orsubjected to gene shuffling, or other well known techniques forgenerating sequence diversity (Tani, P. H., et al. (2002) Biochm. J.,Vol. 365:287-294; Stephanopoulos, G. (2002) Nat. Biotechnol., Vol.20:666-668).

Peptide antagonists of the invention also can be generated usingmolecular evolution techniques as disclosed in Zhao, H., et al. (2002)Cur. Opin. Biotechnol., Vol. 13:104-110 and Guo, Z., et al. (2002)Biochemistry, Vol. 41:10603-10607. Libraries of proteins can begenerated by mutagenesis, gene shuffling or other well known techniquesfor generating molecular diversity. Protein pools representing numerousvariants can be selected for their ability to bind to denaturedcollagen, for instance, by passing such protein pools over a solidmatrix to which a denatured collagen has been attached. Elution withgradients of salt, for example, can provide purification of variantswith affinity for the denatured collagen. A negative selection step alsocan be included whereby such pools are passed over a solid matrix towhich native collagens have been attached. The filtrate will containthose variants with in the pool that have a reduced affinity for thenative form of the collagen.

The peptide and polypeptide antagonists of the present invention alsocan be generated by phage display. Phage display is a selectiontechnique in which a peptide is expressed as a fusion with a coatprotein of a bacteriophage. The result is that the fused protein isdisplayed on the surface of the viron and the DNA encoding the fusionprotein resides within the viron. (Smith G. P. (1985) Filamentous fusionphage: Novel expression vectors that display cloned antigens on theviron surface. Science. 228:1315-1317; Smith G. P., et al. (1993)Libraries of peptides and proteins displayed on filamentous phage.Methods Enzymol. 217:228-257). Phage display allows for rapididentification of peptide ligands for a variety of target moleculesusing an in vitro process called panning. Panning is carried out, forexample, by incubating a library of phage-displayed peptides with amicrotiter plate coated with the target, washing away the unbound phage,and eluting the bound phage. The eluted phage is then amplified andtaken through additional binding/amplification cycles to enrich the poolin favor of binding sequences. After 3-4 rounds of panning, individualclones are identified by DNA sequencing.

A randomized peptide or protein can be expressed on the surface of aphagemid (a term for the combination of phage and plasmid) particle as afusion with a phage coat protein. Techniques of monovalent phage displayare widely available (see, e.g., Lowman H. B. et al. (1991) Biochemistry30:10832-8). Phage expressing randomized peptide or protein librariescan be panned with a solid matrix to which a native collagen moleculehas been attached. Remaining phage do not bind native collagens, or bindnative collagens with substantially reduced affinity. The phage are thenpanned against a solid matrix to which a denatured collagen has beenattached. Bound phage are isolated and separated from the solid matrixby either a change in solution conditions or, for a suitably designedconstruct, by proteolytic cleavage of a linker region connecting thephage coat protein with the randomized peptide or protein library. Theisolated phage can be sequenced to determine the identity of theselected antagonist.

The well known ELISA assay can be used to identify collagen type-IVselective antagonists for use in practicing the present invention. Apeptide or polypeptide can be identified as an antagonist through theuse of a solid phase ELISA to determine whether the peptide orpolypeptide binds to denatured or native collagens. The ELISA assay isuseful with a variety of collagen types; for example, the ELISA assaycan be used with collagens types I, II, III, IV, and V, as well as forother extracellular matrix components. The level of binding affinity canbe determined by surface plasmon resonance technique (analyzed on aBIOCORE 2000 system) (Liljeblad, et al. (2000) Glyco. J., vol.17:323-329) and standard measurements by traditional scatchard bindingassays (Heeley, R. P. (2002) Endocr. Res., Vol. 28:217-229).

Solid phase ELISA also can be used to identify compounds which exhibitspecificity for denatured, but not native, forms of collagen. Thespecificity assay is conducted by running parallel ELISAs where apotential antagonist is screened concurrently in separate assay chambersfor the ability to bind denatured and native collagens.

Antagonists of the invention can also be identified by their ability tobind to a solid matrix containing a denatured collagen. Putativeantagonists are collected after altering solution conditions, such assalt concentration, pH, temperature, or other conditions. The putativeantagonists are further identified by their ability to pass through,under appropriate solution conditions, a solid matrix to which a nativecollagen has been affixed.

Agents of the present invention can be used with collagen type I-IVmolecules from any invertebrate or vertebrate animal, including humans.Examples of collagen type I-IV molecules are found in Engel, J. (1997)Science, Vol. 277:1785-1786 and Gordon, M. K., et al., (1990) Curr.Opin. Cell Biol., Vol. 2:833-838. Preferably, the collagen type-IV is amammalian collagen type-IV. More preferably, the mammal is a pig, cow,goat, rabbit, mouse, rat, dog, cat, sheep, donkey, horse, or mule. Inone particular embodiment, the collagen is human collagen type-IV.

Active agents for use in the invention comprise one or more denaturedcollagen type-IV antagonists. An antagonist of denatured collagen typeI-IV can be any peptide, polypeptide or peptido-mimetic that hassubstantially greater binding affinity to denatured collagen type I-IVthan to the native form of collagen type I-IV and that blocks denaturedcollagen type I-IV biological activity (e.g., cell adhesion). Thepeptide antagonists of the present invention may be modified, forexample, by phosphorylation, hydroxylation or methylation. Additionalmodifications that may enhance activity include peptide cyclization andpeptide stabilization.

Peptide Antagonists of Denatured Collagen and Analogs

Also included in the invention are peptide antagonist of any denaturedcollagen, including but not limited to types I-IV or fragments thereofthat are modified in ways that enhance or do not inhibit their abilityto modulate an inflammatory cell response. In one embodiment, theinvention provides methods for optimizing an amino acid sequence ornucleic acid sequence by producing an alteration. Such changes mayinclude certain mutations, deletions, insertions, or post-translationalmodifications.

In one embodiment, the present invention includes analogs, fragments, orchemical derivatives of a polypeptide whose amino acid residue sequencedelineated herein so long as the peptide is a selective antagonist ofdenatured collagen type I-IV. Therefore, a peptide can be subject tovarious changes, substitutions, insertions, and deletions where suchchanges provide for certain advantages in its use. In this regard, adenatured collagen type I-IV antagonist peptide of this inventionincludes the sequence of a recited peptide where one or more sequencechanges are made and the peptide retains the ability to function as adenatured collagen type I-IV selective antagonist in one or more of theassays as defined herein.

The invention further includes analogs of any naturally-occurringpolypeptide of the invention. Analogs can differ from thenaturally-occurring the polypeptide of the invention by amino acidsequence differences, by post-translational modifications, or by both.Analogs of the invention will generally exhibit at least 85%, morepreferably 90%, and most preferably 95% or even 99% identity with all orpart of a naturally-occurring amino, acid sequence of the invention. Thelength of sequence comparison is at least 10, 13, 15 amino acidresidues, preferably at least 25 amino acid residues, and morepreferably more than 35 amino acid residues. Again, in an exemplaryapproach to determining the degree of identity, a BLAST program may beused, with a probability score between e⁻³ and e⁻¹⁰⁰ indicating aclosely related sequence. Modifications include in vivo and in vitrochemical derivatization of polypeptides, e.g., acetylation,carboxylation, phosphorylation, or glycosylation; such modifications mayoccur during polypeptide synthesis or processing or following treatmentwith isolated modifying enzymes. Analogs can also differ from thenaturally-occurring polypeptides of the invention by alterations inprimary sequence. These include genetic variants, both natural andinduced (for example, resulting from random mutagenesis by irradiationor exposure to ethanemethylsulfate or by site-specific mutagenesis asdescribed in Sambrook, Fritsch and Maniatis, Molecular Cloning: ALaboratory Manual (2d ed.), CSH Press, 1989, or Ausubel et al., supra).Also included are cyclized peptides, molecules, and analogs whichcontain residues other than L-amino acids, e.g., D-amino acids ornon-naturally occurring or synthetic amino acids, e.g., β or γ aminoacids.

In addition to full-length polypeptides, the invention also includesfragments of any one of the polypeptides of the invention. As usedherein, the term “a fragment” means at least 2, 3, 4, 5, 10, 13, or 15amino acids. In other embodiments a fragment is at least 20 contiguousamino acids, at least 30 contiguous amino acids, or at least 50contiguous amino acids, and in other embodiments at least 60 to 80 ormore contiguous amino acids. Fragments of the invention can be generatedby methods known to those skilled in the art or may result from normalprotein processing (e.g., removal of amino acids from the nascentpolypeptide that are not required for biological activity or removal ofamino acids by alternative mRNA splicing or alternative proteinprocessing events).

Non-protein antagonists of denatured collagen type I-IV analogs having achemical structure designed to mimic antagonists functional activity canbe administered according to methods of the invention. Antagonist ofdenatured collagen type I-IV analogs may exceed the physiologicalactivity of the CLK peptide. Methods of analog design are well known inthe art, and synthesis of analogs can be carried out according to suchmethods by modifying the chemical structures such that the resultantanalogs exhibit the modulatory activity of the CLK peptide. Thesechemical modifications include, but are not limited to, substitutingalternative R groups and varying the degree of saturation at specificcarbon atoms of the CLK peptide. Preferably, the CLK peptide analogs arerelatively resistant to in vivo degradation, resulting in a moreprolonged therapeutic effect upon administration. Assays for measuringfunctional activity include, but are not limited to, those described inthe Examples below.

KGGCLK-peptide is one such modified peptide, KGGCLK-peptide isCLK-peptide with sequence KGG added to the N-terminus and GKA added tothe C-terminus. The coupling of the amino acids may be accomplished bytechniques familiar to those in the art and provided, for example, inStewart and Young, 1984, Solid Phase Synthesis, Second Edition, PierceChemical Co., Rockford, Ill.

The antagonist can be conjugated with therapeutic agents or cytotoxinsfor delivery to a site of inflammation or to fibrotic tissue, or otherdisease or condition associated with cellular interactions withdenatured collagen type-IV. Such conjugates can be made with a cytolysinor an exotoxin, for example ricin A, diphtheria toxin A, or Pseudomonasexotoxin and fragments thereof. The cytotoxic agent can also be aradioactively labeled with an isotope so as to locally deliver a toxicdose of radioactivity to a tissue undergoing cellular interaction withdenatured collagen type-IV.

Denatured Collagen Binding Assays

The invention also provides assay methods for identifying agents thatbind to denatured collagen for use in reducing inflammation, fibrosis,UV radiation damage, or any other method delineated herein. In theseassays, agents are evaluated for their ability to bind both denaturedcollagen and native collagen, and furthermore can be evaluated for theirefficacy in reducing the binding of one or more types of inflammatorycells to denatured collagen.

A first assay measures binding of agents to denatured or nativecollagens in the solid phase by ELISA. The assay is useful with avariety of types of collagens, for example, the assay can be used withcollagens types I, II, III, IV and V, as well as for other extracellularmatrix components.

The assay also can be used to identify compounds which exhibitspecificity for denatured but not native forms of collagen. Thespecificity assay is conducted by running parallel ELISAs where apotential antagonist is screened concurrently in separate assay chambersfor the ability to bind denatured and native collagens.

Antagonists of denatured collagen can also be identified by theirability to compete for binding with a known denatured collagenantagonist. For example, antagonists can be identified by monitoringtheir effect on the affinity of binding to denatured collagen of a knownantagonist, such as HUI77 or D93, or in a binding assay, such as ELISA.Such antagonists likely have the same specificity as HUI77, andrecognize the same cryptic epitope. Antagonists can be selected from theputative antagonists by conventional binding assays to determine thosethat bind to the denatured collagen epitope but not to the knownantagonist.

Antagonists can also be identified by their ability to bind to a solidmatrix containing a denatured collagen. Such putative antagonists arecollected after altering solution conditions, such as saltconcentration, pH, temperature, and other conditions. The putativeantagonists are further identified by their ability to pass through,under appropriate solution conditions, a solid matrix to which a nativecollagen has been affixed.

Non-Peptide Agents

The invention also provides small organic molecules, such as thosenatural products, or those compounds synthesized by conventional organicsynthesis or combinatorial organic synthesis that selectively bind todenatured collagen and thereby inhibit the binding of an inflammatorycell. Compounds can be tested for their ability to bind to a denaturedcollagen, for example, by using the column binding technique describedabove. Compounds also are selected for reduced affinity for the nativeform of the collagen by a similar column binding technique.

Other suitable non-peptidic compounds include, for example,oligonucleotides. Oligonucleotides as used herein refers to anyheteropolymeric material containing purine, pyrimidine and otheraromatic bases. DNA and RNA oligonucleotides are suitable for use withthe invention, as are oligonucleotides with sugar (e.g., 2′ alkylatedriboses) and backbone modifications (e.g., phosphorothioateoligonucleotides). Oligonucleotides may present commonly found purineand pyrimidine bases such as adenine, thymine, guanine, cytidine anduridine, as well as bases modified within the heterocyclic ring portion(e.g., 7-deazaguanine) or in exocyclic positions. Oligonucleotide alsoencompasses heteropolymers with distinct structures that also presentaromatic bases, including polyamide nucleic acids and the like.

An oligonucleotide antagonist of the invention can be generated by anumber of methods known to one of skill in the art. In one embodiment, apool of oligonucleotides is generated containing a large number ofsequences. Pools can be generated, for example, by solid phase synthesisusing mixtures of monomers at an elongation step. The pool ofoligonucleotides is sorted by passing a solution-containing the poolover a solid matrix to which a denatured collagen or fragment thereofhas been affixed. Sequences within the pool that bind to the denaturedcollagen are retained on the solid matrix. These sequences are elutedwith a solution of different salt concentration or pH. Sequencesselected are subjected to a second selection step. The selected pool ispassed over a second solid matrix to which native collagen has beenaffixed. The column retains those sequences that bind to the nativecollagen, thus, enriching the pool for sequences specific for thedenatured collagen. The pool can be amplified and, if necessary,mutagenized and the process repeated until the pool shows thecharacterstics of an antagonist of the invention. Individual antagonistscan be identified by sequencing members of the oligonucleotide pool,usually after cloning said sequences into a host organism such as E.coli.

Antibodies

In certain preferred embodiments, the present invention providesdenatured collagen antagonists in the form of antibodies. Antibodyantagonists as described by the present invention can be used to alterthe activity of one or more types of inflammatory cells in a subject.Antibody antagonists as described by the present invention can be usedto treat or prevent fibrosis or inflammation.

Antibodies are well known to those of ordinary skill in the science ofimmunology. As used herein, the term “antibodies” includes polyclonalantibodies, affinity-purified polyclonal antibodies, monoclonalantibodies, and antigen-binding fragments, such as F(ab′)2 and Fabproteolytic fragments. Genetically engineered intact antibodies orfragments, such as chimeric antibodies, Fv fragments, single chainantibodies, and the like, as well as synthetic antigen-binding peptidesand polypeptides, are also included. Non-human antibodies may behumanized by grafting non-human CDRs onto human framework and constantregions, or by incorporating the entire non-human variable domains. Incertain preferred embodiments, humanized antibodies may retain non-humanresidues within the human variable region framework domains to enhanceproper binding characteristics. Through humanizing antibodies,biological half-life may be increased, and the potential for adverseimmune reactions upon administration to humans is reduced. Monoclonalantibodies can also be produced in mice that have been geneticallyaltered to produce antibodies that have a human structure.

“Antibody” means not only intact antibody molecules, but also fragmentsof antibody molecules that retain immunogen binding ability. Suchfragments are also well known in the art and are regularly employed bothin vitro and in vivo. Accordingly, as used herein, the term “antibody”means not only intact immunoglobulin molecules but also the well-knownactive fragments F(ab′)₂, and Fab. F(ab′)₂, and Fab fragments which lackthe Fc fragment of intact antibody, clear more rapidly from thecirculation, and may have less non-specific tissue binding of an intactantibody (Wahl et al., J. Nucl. Med. 24:316-325 (1983).

Examples of antibodies include monoclonal antibodies, polyclonalantibodies, the preparation and use of which are known to the skilledartisan. Other exemplary antibodies include whole native antibodies,bispecific antibodies, Fab, Fab′, single chain V region fragments (scFv)and fusion polypeptides. The invention also encompasses hybridantibodies, in which one pair of heavy and light chains is obtained froma first antibody, while the other pair of heavy and light chains isobtained from a different second antibody. Such hybrids may also beformed using humanized heavy and light chains. Such antibodies are oftenreferred to as “chimeric” antibodies.

The phrase “monoclonal antibody” refers to a population of antibodymolecules that contain only one species of antibody combining sitecapable of immunoreacting with a particular epitope. A monoclonalantibody may therefore contain an antibody molecule having a pluralityof antibody combining sites, each immunospecific for a differentepitope, e.g., a bispecific monoclonal antibody.

In certain preferred embodiments, monoclonal antibodies whichpreferentially bind to denatured collagen include monoclonal antibodieshaving the immunoreaction characteristics of mAb HUI77, mAb D93, mAbHUIV26 or mAb XL313.

In general, intact antibodies are said to contain “Fc” and “Fab”regions. The Fc regions are involved in complement activation and arenot involved in antigen binding. An antibody from which the Fc′ regionhas been enzymatically cleaved, or which has been produced without theFc′ region, designated an “F(ab′)₂” fragment, retains both of theantigen binding sites of the intact antibody. Similarly, an antibodyfrom which the Fc region has been enzymatically cleaved, or which hasbeen produced without the Fc region, designated an “Fab” fragment,retains one of the antigen binding sites of the intact antibody. Fab′fragments consist of a covalently bound antibody light chain and aportion of the antibody heavy chain, denoted “Fd.” The Fd fragments arethe major determinants of antibody specificity (a single Fd fragment maybe associated with up to ten different light chains without alteringantibody specificity). Isolated Fd fragments retain the ability tospecifically bind to immunogenic epitopes.

Antibodies can be made by any of the methods known in the art, where thetarget is denatured collagen, preferably denatured collagen type-IV, andin particular, wherein the target is a cryptic collagen epitope asdescribed herein (e.g., the CLK/HU177 or CLK/D93 cryptic epitope), orimmunogenic fragments thereof, as an immunogen.

An “epitope” is a region of a protein to which an antibody can bind.See, for example, Geysen et al., Proc. Natl. Acad. Sci. USA81:3998-4002, 1984. Epitopes can be linear or conformational, the latterbeing composed of discontinuous regions of the protein that form anepitope upon folding of the protein. Linear epitopes are generally atleast 6 amino acid residues in length. Relatively short syntheticpeptides that mimic part of a protein sequence are routinely capable ofeliciting an antiserum that reacts with the partially mimicked protein.See, Sutcliffe et al., Science 219:660-666, 1983. Immunogenic,epitope-bearing polypeptides contain a sequence of at least six, oftenat least nine, more often from 15 to about 30 contiguous amino acidresidues of denatured collagen (e.g., collagen type I-IV).

In certain embodiments, an agent of the invention specifically binds toan epitope of denatured collagen (e.g., collagen type I-IV). Inparticular embodiments, the epitope comprises at least a core GLPGPamino acid sequence. Such sequences are present in may different typesof collagen (e.g., collagen type I-IV).

In certain preferred examples, the epitope corresponds toOGAKGLPGPOGPOGPY, SEQ ID NO: 1, where O represents hydroxylatedprolines. Polypeptides comprising a larger portion of a denaturedcollagen (e.g., collagen type I-IV), i.e., from 30 to 50 residues, up tothe entire sequence are included.

One method of obtaining antibodies is to immunize suitable host animalswith an immunogen and to follow standard procedures for polyclonal ormonoclonal antibody production. The immunogen will facilitatepresentation of the immunogen on the cell surface. Immunization of asuitable host can be carried out in a number of ways. Nucleic acidsequences encoding a cryptic collagen epitope as described herein (e.g.,the CLK/HU177 or CLK/D93 cryptic epitope), or immunogenic fragmentsthereof, can be provided to the host in a delivery vehicle that is takenup by immune cells of the host. The cells will in turn express thereceptor on the cell surface generating an immunogenic response in thehost. Alternatively, nucleic acid sequences encoding a cryptic collagenepitope as described herein (e.g., the CLK/HU177 or CLK/D93 crypticepitope), or immunogenic fragments thereof, can be expressed in cells invitro, followed by isolation of the receptor and administration of thereceptor to a suitable host in which antibodies are raised.

Using either approach, antibodies can then be purified from the host.Antibody purification methods may include salt precipitation (forexample, with ammonium sulfate), ion exchange chromatography (forexample, on a cationic or anionic exchange column, preferably run atneutral pH and eluted with step gradients of increasing ionic strength),gel filtration chromatography (including gel filtration HPLC), andchromatography on affinity resins such as protein A, protein G,hydroxyapatite, and anti-immunoglobulin.

Antibodies can be conveniently produced from hybridoma cells engineeredto express the antibody. Methods of making hybridomas are well known inthe art. The hybridoma cells can be cultured in a suitable medium, andspent medium can be used as an antibody source. Polynucleotides encodingthe antibody of interest can in turn be obtained from the hybridoma thatproduces the antibody, and then the antibody may be producedsynthetically or recombinantly from these DNA sequences. For theproduction of large amounts of antibody, it is generally more convenientto obtain an ascites fluid. The method of raising ascites generallycomprises injecting hybridoma cells into an immunologically naivehistocompatible or immunotolerant mammal, especially a mouse. The mammalmay be primed for ascites production by prior administration of asuitable composition, e.g., Pristane.

Monoclonal antibodies (Mabs) can be “humanized” by methods known in theart. “Humanized” antibodies are antibodies in which at least part of thesequence has been altered from its initial form to render it more likehuman immunoglobulins. Techniques to humanize antibodies areparticularly useful when non-human animal (e.g., murine) antibodies aregenerated. Examples of methods for humanizing a murine antibody areprovided in U.S. Pat. Nos. 4,816,567, 5,530,101, 5,225,539, 5,585,089,5,693,762 and 5,859,205.

In particular embodiments of the invention, an antibody is used todetect a non-cellular cryptic collagen epitope. The antibody can beprepared against any non-cellular cryptic collagen epitope usingtechniques discussed and known to one of ordinary skill in the art. Inone example, to detect a collagen cryptic epitope, the antibody can beprepared against the sequence OGAKGLPGPOGPOGPY, SEQ ID NO: 1).

In certain cases, the immunogenicity of a polypeptide immunogen may beincreased through the use of an adjuvant.

Alternative techniques for generating or selecting antibodies include invitro exposure of lymphocytes to a polypeptide immunogen, and selectionof antibody display libraries in phage or similar vectors (for instance,through use of immobilized or labeled polypeptide). Techniques forcreating and screening such random peptide display libraries are knownin the art (e.g., Ladner et al., U.S. Pat. No. 5,223,409; Ladner et al.,U.S. Pat. No. 4,946,778; Ladner et al., U.S. Pat. No. 5,403,484 andLadner et al., U.S. Pat. No. 5,571,698), and random peptide displaylibraries and kits for screening such libraries are availablecommercially, for instance from Clontech Laboratories (Palo Alto,Calif.), Invitrogen Inc. (San Diego, Calif.), New England Biolabs, Inc.(Beverly, Mass.), and Pharmacia LKB Biotechnology Inc. (Piscataway,N.J.). Random peptide display libraries can be screened using theepitope sequences disclosed herein to identify proteins that bind topreferred epitopes.

Antibodies are determined to be specifically binding if they bind totheir intended target (e.g., denatured collagen types I, II, III, IV)with a greater affinity than the binding affinity to control (e.g.,non-denatured collagen type-IV) polypeptide or protein. The bindingaffinity of an antibody can be readily determined by one of ordinaryskill in the art, for example, by Scatchard analysis (Scatchard, G.,Ann. NY Acad. Sci. 51: 660-672, 1949). Methods for screening andisolating specific antibodies are well known in the art. See, forexample, Paul (ed.), Fundamental Immunology, Raven Press, 1993; Getzoffet al., Adv. in Immunol. 43:1-98, 1988; Goding (ed.), MonoclonalAntibodies: Principles and Practice, Academic Press Ltd., 1996; andBenjamin et al., Ann. Rev. Immunol. 2:67-101, 1984.

A variety of assays known to those skilled in the art can be utilized todetect antibodies that specifically bind to denatured collagen (e.g.,denatured collagen types I, II, III, IV). Exemplary assays are describedin detail in Antibodies: A Laboratory Manual, Harlow and Lane (Eds.),Cold Spring Harbor Laboratory Press, 1988. Representative examples ofsuch assays include: concurrent immunoelectrophoresis, radioimmunoassay,radioimmuno-precipitation, enzyme-linked immunosorbent assay (ELISA),dot blot or Western blot assays, inhibition or competition assays, andsandwich assays.

Methods of Treatment

The present invention describes a novel method to prevent and/or inhibitinflammation and fibrosis by targeting denatured collagen, and inparticular denatured collagen type-IV, with antagonists. The methods ofthe present invention selectively prevent or reduce infiltration of themany of the diverse cell types known to contribute to inflammation andfibrosis, rather than inhibiting the action of one individual molecule,and so represent a much more efficacious clinical approach to treatinflammation and fibrosis.

The invention provides methods for treating or preventing fibrosis orinflammation in a subject comprising administering to the subject acomposition comprising a therapeutically effective amount of an agent(e.g., proteins, peptides, antibodies, aptamers, oligopeptides and smallmolecule inhibitors) that selectively binds denatured collagen (e.g.,denatured collagen types I, II, III, IV).

In other aspect, the methods of the invention can be used to treatcancer. Accordingly, the invention features methods of treating orpreventing the development or spread of cancer in a subject comprisingadministering to the subject a composition comprising a therapeuticallyeffective amount of an agent that binds denatured collagen (e.g.,denatured collagen types I, II, III, IV). Examples of cancers include,without limitation, leukemias (e.g., acute leukemia, acute lymphocyticleukemia, acute myelocytic leukemia, acute myeloblastic leukemia, acutepromyelocytic leukemia, acute myelomonocytic leukemia, acute monocyticleukemia, acute erythroleukemia, chronic leukemia, chronic myelocyticleukemia, chronic lymphocytic leukemia), polycythemia vera, lymphoma(Hodgkin's disease, non-Hodgkin's disease), Waldenstrom'smacroglobulinemia, heavy chain disease, and solid tumors such assarcomas and carcinomas (e.g., fibrosarcoma, myxosarcoma, liposarcoma,chondrosarcoma, osteogenic sarcoma, chordoma, angiosarcoma,endotheliosarcoma, lymphangiosarcoma, lymphangioendotheliosarcoma,synovioma, mesothelioma, Ewing's tumor, leiomyosarcoma,rhabdomyosarcoma, colon carcinoma, pancreatic cancer, breast cancer,ovarian cancer, prostate cancer, squamous cell carcinoma, basal cellcarcinoma, adenocarcinoma, sweat gland carcinoma, sebaceous glandcarcinoma, papillary carcinoma, papillary adenocarcinomas,cystadenocarcinoma, medullary carcinoma, bronchogenic carcinoma, renalcell carcinoma, hepatoma, nile duct carcinoma, choriocarcinoma,seminoma, embryonal carcinoma, Wilm's tumor, cervical cancer, uterinecancer, testicular cancer, lung carcinoma, small cell lung carcinoma,bladder carcinoma, epithelial carcinoma, glioma, astrocytoma,medulloblastoma, craniopharyngioma, ependymoma, pinealoma,hemangioblastoma, acoustic neuroma, oligodenroglioma, schwannoma,meningioma, melanoma, neuroblastoma, and retinoblastoma). In certainpreferred examples, the cancer is melanoma. In other preferred examples,the antagonist is administered prior to the onset of the cancer.

Fibroproliferative Diseases

Fibroproliferative disorders are characterized by the abnormalaccumulation of fibrous tissue (“fibrosis”) that can occur as a part ofthe wound-healing process in damaged tissue. Such tissue damage mayresult from physical injury, inflammation, infection, exposure totoxins, and/or other causes. The fibroproliferative condition includesboth a cell growth component and an extensive phase characterized byextracellular matrix accumulation. Fibroproliferative diseases, include,for example, excessive skin scarring, keloid formation, myocardialscarring, vascular restenosis, intestinal stricture formation, thoracicand abdominal postsurgical adhesion formation, articular, pannusformation, pulmonary fibroses, systemic sclerosis, liver cirrhosis,cardiovascular disease, progressive kidney disease, and maculardegeneration, and can affect all tissues and organ systems. Further,fibrotic tissue remodeling can also influence cancer metastasis andaccelerate chronic graft rejection in transplant recipients.

Pathogenic fibrosis is often associated with a chronic inflammatoryreaction. A chronic inflammatory reaction is one that lasts for severalweeks (e.g., 2, 3, 4, 5, or 6 weeks) or months (e.g., 2, 3, 4, 5, 6, 8,9, 10, 11, 12 months or longer) and generally includes inflammation,tissue destruction, and/or repair processes. In general, chronicfibrotic disorders have in common a persistent irritant that sustainsthe production of growth factors, proteolytic enzymes, angiogenicfactors, and fibrogenic cytokines, which together stimulate thedeposition of connective tissue elements that progressively remodel anddestroy normal tissue architecture (Tomasek J. J et al. Nat. Rev. Mol.Cell Biol. 2002; Friedman S. L., Nat. Clin. Pract. Gastroenterol.Hepatol. 2004).

Pulmonary fibrosis is a major cause of morbidity and mortality. In oneembodiment, pulmonary fibrosis is associated with the use of high-doseantineoplastic agents (e.g., bleomycin) in chemotherapy and with bonemarrow transplantation for cancer treatment. The development of lungdisease is the major dose-limiting side effect of bleomycin. See, Tranet al., J. Clin. Invest. 99:608-617, 1997. Idiopathic pulmonary fibrosis(IPF) is another lung fibrotic disease characterized by afibroproliferative response. Various factors, including aspiration andexposure to environmental pollutants may result in IPF (Egan, The Lancet354:1839-1840, 1999). The standard treatment for IPF is oralglucocorticoids. However, lung function improves in less than 30 percentof patients who receive this treatment, and, regardless of treatment,the median survival is four to five years after the onset of symptoms.The proliferation of fibroblasts and the accumulation of interstitialcollagens are the hallmarks of progressive organ fibrosis; however, thebiochemical mechanism of induction of lung fibrosis remains unclear(Ziesche et al., New Eng. J. Med. 341:1264-1269, 1999; Kuwano et al., J.Clin Invest. 104:13-19, 1999). Pulmonary hypertension results from avariety of initiating stimuli. Its progression is associated withpulmonary vascular sclerosis, which includes abnormal endothelialmorphology and function, muscularization of normally nonmuscularperipheral arteries related to differentiation of pericytes, and medialhypertrophy and neointimal formation in muscular arteries as aconsequence of hypertrophy, proliferation, and migration of residentsmooth muscle cells and increased production of extracellular matrixcomponents. These components include collagen, elastin, fibronectin, andtenascin-C. This fibroproliferative response can progress tolife-threatening pulmonary arterial obstructive disease (Cowan et al.,J. Clin. Invest. 105:21-34, 2000).

Fibroproliferative disorders of the lung include, but are not limitedto, for example, silicosis, asbestosis, idiopathic pulmonary fibrosis,bronchiolitis obliterans-organizing pneumonia, pulmonary fibrosisassociated with high-dose chemotherapy, idiopathic pulmonary fibrosis,and pulmonary hypertension. These diseases are characterized by cellproliferation and increased production of extracellular matrixcomponents, such as collagens, elastin, fibronectin, and tenascin-C.

Effects of the antagonists of the present invention on lung fibrosis canalso be assayed in a mouse model using bleomycin. The chemotherapy agentbleomycin is a known causative agent of pulmonary fibrosis in humans andcan induce interstitial lung disease in mice, including an increase inthe number of fibroblasts, enhanced collagen deposition, anddysregulated matrix remodeling. C57Bl/6 mice are administered bleomycinby osmotic minipump for 1 week. There follows a period of inflammation,with cutaneous toxicity beginning approximately 4-7 days after bleomycinadministration and continuing for about a week, after which the miceappear to regain health. About 3-4 weeks after the finish of bleomycindelivery, the mice are sacrificed, and the lungs are examinedhistologically for signs of fibrosis. Scoring is based on the extent oflung fibrotic lesions and their severity. Serum is assayed for lacticdehydrogenase, an intracellular enzyme that is released into thecirculation upon general cell death or injury. Lung tissue is assayedfor hydroxyproline as a measure of collagen deposition.

Fibroproliferative disorders of the vasculature include, for example,transplant vasculopathy, which is a major cause of chronic rejection ofheart transplantation. Transplant vasculopathy is characterized byaccelerated atherosclerotic plaque formation with diffuse occlusion ofthe coronary arteries, which is a “classic” fibroproliferative disease.See, Miller et al., Circulation 101:1598-1605, 2000).

Liver fibrosis is the excessive accumulation of extracellular matrixproteins including collagen that occurs in most types of chronic liverdiseases. Advanced liver fibrosis results in cirrhosis, liver failure,and portal hypertension and often requires liver transplantation.

A variety of renal diseases can be classified as fibroproliferative.Glomerular (usually mesangial) cell proliferation occurs in many typesof glomerulonephritides in conjunction with increased extracellularmatrix accumulation (Iida et al., Proc. Natl. Acad. Sci. USA88:6560-6564, 1991). For example, mesangial cell proliferation precedesglomerulosclerosis in the remnant kidney model (Floege et al., KidneyInternational 41:297-309, 1992), and experimental overexpression ofgrowth factors such as PDGF-B and TGF-beta in the kidney induces cellproliferation, matrix accumulation, and glomerulosclerosis (Isaka etal., J. Clin. Invest. 92:2597-2601, 1993; Cybulsky, Curr. Opin.Nephropathy and Hypert. 9:217-223, 2000).

Fibroproliferative disorders of the kidney include, but are not limitedto, glomerulonephritis (including membranoproliferative, diffuseproliferative, rapidly progressive, and chronic forms), diabeticglomerulosclerosis, focal glomerulosclerosis, diabetic nephropathy,lupus nephritis, tubulointerstitial fibrosis, membranous nephropathy,amyloidosis (which affects the kidney among other tissues), renalarteriosclerosis, and nephrotic syndrome. The glomerulus is a majortarget of many types of renal injury, including immunologic (e.g.,immune-complex- or T-cell-mediated), hemodynamic (systemic or renalhypertension), metabolic (e.g., diabetes), “atherosclerotic”(accumulation of lipids in the glomerulus), infiltrative (e.g.,amyloid), and toxic (e.g., snake venom) injuries (Johnson, Kidney Int.45:1769-1782, 1994). The renal structural changes in patients withdiabetic nephropathy include hypertrophy of the glomerulus, thickeningof the glomerular and tubular membranes (due to accumulated matrix), andincreased amounts of matrix in the measangium and tubulointerstitium(Ziyadeh et al., Proc. Natl. Acad. Sci. USA 97:8015-8020, 2000).Glomerular hypertension due to intrarenal hemodynamic changes indiabetes can contribute to the progression of diabetic nephropathy(Ishida et al., Diabetes 48:595-602, 1999). Autoimmune nephritis canalso lead to altered mesangial cell growth responses (Liu and Ooi, J.Immunol. 151:2247-2251, 1993). Infection by hepatitis-C virus can alsoresult in idiopathic membranoproliferative glomerulonephritis (Johnsonet al., N. Engl. J. Med. 328:465-470, 1993).

Effects of antagonists of the invention on liver and kidney fibrosis canbe tested in known animal models, such as the db/db mouse modeldisclosed by Cohen et al., Diabetologia 39:270-274, 1996 and Cohen etal., J. Clin. Invest. 95:2338-2345, 1995, or transgenic animal models(Imai et al., Contrib. Nephrol. 107:205-215, 1994).

Inflammation Associated Diseases

Inflammation is the result of a complex series of molecular signalsinvolving the immune system, usually in response to infection orcellular or tissue damage. Inflammation normally constitutes the body'sinitiation of healing; however, when it is not properly regulatedinflammation can result in chronic diseases, such as arthritis.

By “inflammatory response” or “immune response” is meant the reaction ofliving tissues to injury, infection or irritation characterized byredness, warmth, swelling, pain, and loss of function produced, as theresult of increased blood flow and an influx of immune cells andsecretions. Inflammation is the body's reaction to invading infectiousmicroorganisms and results in an increase in blood flow to the affectedarea, the release of chemicals that attract white blood cells, anincreased flow of plasma, and the arrival of monocytes to clean up thedebris. Anything that stimulates the inflammatory response is said to beinflammatory.

The innate cascade, or the innate immune response, is the non-specificresponse mounted by the immune system and is characterized by theinfiltration of cells, such as leukocytes, natural killer cells, mastcells, eosinophils and basophils, as well as phagocytes, such asneutrophils, macrophages and dendritic cells in response to chemotaticsignaling at the site of injury or infection. Molecules secreted by theaforementioned cells, such as histamine and various cytokines; and thecomplement system of circulating proteins contribute to inflammation.Diseases characterized by inflammation are significant causes ofmorbidity and mortality in humans. Commonly, inflammation occurs as adefensive response to invasion of the host by foreign, particularlymicrobial, material. Responses to mechanical trauma, toxins, andneoplasia also may results in inflammatory reactions.

In certain embodiments, the inflammatory disorder is a rheumatoiddisorder. Rheumatoid disorders, as used herein, refer to any of avariety of inflammatory disorders characterized by inflammation, andsometimes degeneration and/or metabolic derangement, of the connectivetissue structures, especially the joints, ligaments, and tendons.Rheumatoid disorders typically result in pain, stiffness, and/orlimitation of motion. The particular tissue or tissues effected dependson the rheumatoid disorder. Exemplary rheumatoid disorders include, butare not limited to, rheumatoid arthritis, juvenile arthritis, bursitis,spondylitis, gout, scleroderma, Still's disease, and vasculitis.

In certain embodiments, the rheumatoid disorder is rheumatoid arthritisand “treating” rheumatoid arthritis includes decreasing the severity,frequency, and/or occurrence of one or more of the symptoms ofrheumatoid arthritis. In other embodiments, the rheumatoid disorder isjuvenile arthritis, bursitis, spondylitis, gout, scleroderma, Still'sdisease, or vasculitis. Methods of the invention decrease the severity,frequency, and/or occurrence of any one or more of the symptoms of theseconditions.

In various embodiments, symptoms of arthritis or other inflammatorydiseases include redness, swelling, inflammation, fever, decreased rangeof motion, and pain. Examples of reducing the occurrence or severity ofsymptoms include, but are not limited to, decreasing the number ofswollen joints, decreasing the number of painful joints, decreasing thereliance on pain medication, decreasing a patient's self-evaluation ofthe frequency or severity of their pain, increasing freedom of motion,increasing mobility, decreasing fever, and increasing the ability toperform daily tasks.

Neuroinflammation, characterized by activated microglia and astrocytesand local expression of a wide range of inflammatory mediators, is afundamental reaction to brain injury, whether by trauma, stroke,infection, or neurodegeneration. This local tissue response is thoughtto be part of a repair and restorative process. Like many inflammatoryconditions in peripheral diseases, neuroinflammation can contribute tothe pathophysiology of CNS disorders. For example, in Alzheimer'sdisease (AD), glial-driven inflammatory responses to Aβ deposition arethought to promote neurodegeneration, as evidenced by the extent ofneuroinflammation in AD, increased risk for AD with certainpolymorphisms of proinflammatory cytokine genes, and reduction indisease risk for individuals taking nonsteroidal anti-inflammatory drugs(NSAIDs).

In certain embodiment, the inflammatory disorder is an inflammatory skindisorder. Inflammatory skin disorders include but are not limited torosacea, atopic dermatitis, acne, seborrheic dermatitis, and cellulitis.

In other embodiments, the inflammatory disease is an ischemic orinflammatory cardiovascular disease. An inflammatory cardiovasculardisease or disorder may be, but is not limited to, an occlusive diseaseor disorder, atherosclerosis, a cardiac valvular disease, stenosis,restenosis, in-stent-stenosis, myocardial infarction, coronary arterialdisease, acute coronary syndromes, congestive heart failure, anginapectoris, myocardial ischemia, or thrombosis. In other embodiments, thesite is a secondary site of ischemic injury, such as the CNS or kidney.

In other embodiments, the inflammatory disease is an ischemic orinflammatory bowel disease.

Inflammatory bowel disease (IBD) refers to a chronic recurrentinflammatory disease of unclear etiology affecting the small intestineand colon that includes both Crohn's disease (CD) and ulcerative colitis(UC). Crohn's disease can involve any portion of the intestinal tractbut most commonly involves the distal small intestine and/or the colon.Ulcerative colitis involves only the colon, generally limited to therectum or distal colon. Studies of murine models of CD and UC stronglysuggest that both of these diseases are due to dysregulation of themucosal immune response to antigens in the mucosal microflora (Sartor,R. B. (1995). Gastroenterol Clin North Am 24, 475-507) (Strober W, etal. (2002) Annu. Rev. Immunol. 20:495-549).

Ulcerative colitis or indeterminate colitis refers to a condition of thecolon characterized by a state of inflammation in which one or more ofthe following histological characteristics are detectable: a superficialinflammation characterized by the presence of epithelial cell loss andpatchy ulceration, pronounced depletion of mucin producing-goblet cells,and reduction of the density of the tubular glands. In addition, in thelamina propia, a mixed inflammatory cell infiltrate consisting oflymphocytes and granulocytes (the latter consisting mostly ofneutrophils and, to a lesser extent, eosinophils) associated with anexudation of cells into the bowel lumen is observed. Also, thesubmucosal level can display marked edema with few inflammatory cells,while in the outer muscle layer one of skill in the art would see littleor no evidence of inflammation. See e.g. Boirivant et al. Journal ofExperimental Medicine 188: 1929-1939 (1998). Clinical symptoms caninclude, but are not limited to, diarrhea, rectal prolapse, weight loss,abdominal pain, and dehydration.

Crohn's disease refers to inflammation affecting any part of thealimentary tract but most often affecting the terminal part of the smallbowel and/or the adjacent ascending colon. Frequently, the inflammationis characterized by “skip lesions” consisting of areas of inflammationalternating with areas of normal mucosa. The affected area of bowel inCrohn's is marked by erythema, edema and increased friability; at timesthe bowel is strictured and attached to other abdominal organs or to thebowel wall. Fistulae between the affected bowel and other structuresincluding the skin are not infrequent. Microscopic examination of thetissue in Crohn's disease reveals epithelial erosions, loss ofmucin-producing goblet cells and an extensive lymphocytic infiltrationinvolving all layers of the mucosa; this infiltrate sometimes containsgiant cells indicative of granuloma formation. When inflammation ispresent for a long time (chronic), it sometimes can cause scarring(fibrosis). Scar tissue is typically not as flexible as healthy tissue.Therefore, when fibrosis occurs in the intestines, the scarring maynarrow the width of the passageway (lumen) of the involved segments ofthe bowel. These constricted areas are called strictures. The stricturesmay be mild or severe, depending on how much they block the contents ofthe bowel from passing through the narrowed area. Clinicalsigns/symptoms of Crohn's disease can include but are not limited to:cachexia, weight loss, poor growth, abdominal pain, draining fistulae,rectal prolapse and dehydration.

In certain embodiments, an inflammatory hepatic disease or disorder. Forexample, an inflammatory hepatic disease or disorder is selected fromthe group consisting of autoimmune hepatitis, hepatic cirrhosis, andbiliary cirrhosis.

Pharmaceutical Compositions and Administration

The present invention contemplates pharmaceutical preparationscomprising an agent that binds to denatured collagen (e.g., collagentype I-IV), in particular denatured collagen type-IV, together with apharmaceutically acceptable carrier. Polypeptides of the invention maybe administered as part of a pharmaceutical composition. Thecompositions should be sterile and contain a therapeutically effectiveamount of the polypeptides in a unit of weight or volume suitable foradministration to a subject.

As used herein, the terms “pharmaceutically acceptable”,“physiologically tolerable” and grammatical variations thereof, as theyrefer to compositions, carriers, diluents and reagents, are usedinterchangeably and represent that the materials are capable ofadministration to or upon a mammal.

The active ingredient can be mixed with excipients which arepharmaceutically acceptable and compatible with the active ingredientand in amounts suitable for use in the therapeutic methods describedherein. Suitable excipients are, for example, water, saline, dextrose,glycerol, ethanol or the like and combinations thereof. In addition, ifdesired, the composition can contain minor amounts of auxiliarysubstances such as wetting or emulsifying agents, pH buffering agentsand the like which enhance the effectiveness of the active ingredient.

The therapeutic composition of the present invention can includepharmaceutically acceptable salts of the components therein.Pharmaceutically acceptable salts include the acid addition salts(formed with the free amino groups of the polypeptide) that are formedwith inorganic acids such as, for example, hydrochloric or phosphoricacids, or such organic acids as acetic, tartaric, mandelic and the like.Salts formed with the free carboxyl groups also can be derived frominorganic bases such as, for example, sodium, potassium, ammonium,calcium or ferric hydroxides, and such organic bases as isopropylamine,trimethyl amine, 2-ethylamino ethanol, histidine, procaine and the like.Particularly preferred are the salts of TFA and HCl.

Physiologically tolerable carriers are well known in the art. Exemplaryof liquid carriers are sterile aqueous solutions that contain nomaterials in addition to the active ingredients and water, or contain abuffer such as sodium phosphate at physiological pH value, physiologicalsaline or both, such as phosphate-buffered saline. Still further,aqueous carriers can contain more than one buffer salt, as well as saltssuch as sodium and potassium chlorides, dextrose, polyethylene glycoland other solutes.

Liquid compositions also can contain liquid phases in addition to and tothe exclusion of water. Exemplary of such additional liquid phases areglycerin, vegetable oils such as cottonseed oil, and water-oilemulsions.

A therapeutic composition contains an inflammation inhibiting amount ora fibrosis inhibiting amount of an denatured collagen antagonist of thepresent invention, typically formulated to contain an amount of at least0.1 weight percent of antagonist per weight of total therapeuticcomposition. A weight percent is a ratio by weight of inhibitor to totalcomposition. Thus, for example, 0.1 weight percent is 0.1 grams ofinhibitor per 100 grams of total composition.

These compositions can be stored in unit or multi-dose containers, forexample, sealed ampoules or vials, as an aqueous solution or as alyophilized formulation for reconstitution. As an example of alyophilized formulation, 10 mL vials are filled with 5 mL ofsterile-filtered 1% (w/v) aqueous antagonist polypeptide solution, andthe resulting mixture can then be lyophilized. The infusion solution canbe prepared by reconstituting the lyophilized material using sterileWater-for-Injection (WFI).

The compositions can be administered in effective amounts. The effectiveamount will depend upon the mode of administration, the particularcondition being treated, and the desired outcome. It may also dependupon the stage of the condition, the age and physical condition of thesubject, the nature of concurrent therapy, if any, and like factors wellknown to the medical practitioner. For therapeutic applications, it isthat amount sufficient to achieve a medically desirable result.

The dosage ranges for the administration of the denatured collagenantagonist depend upon the form of the antagonist, and its potency, asdescribed further herein, and are amounts large enough to produce thedesired effect in which inflammation or fibrosis and the diseasesymptoms mediated by inflammation or fibrosis are ameliorated. Thedosage should not be so large as to cause adverse side effects, such ashyperviscosity syndromes, pulmonary edema, congestive heart failure, andthe like. Generally, the dosage will vary with the age, condition, sexand extent of the disease in the patient and can be determined by one ofskill in the art. The dosage also can be adjusted by the individualphysician in the event of any complication.

A therapeutically effective amount is an amount of denatured collagenantagonist sufficient to produce a measurable inhibition of inflammationor fibrosis in the tissue being treated. Fibrosis can be measured byvarious non-invasive methods including palpation, ocular examination,retinal examination, X-ray, ultrasound, MRI, as well as invasive methodssuch as biopsy with histopathological examination and molecular markeranalysis, endoscopy, isotope incorporation and gamma scintigraphy.Inflammation can be measured noninvasively by palpation, ocularexamination, retinal examination, assessment of body and tissuetemperature, and functional evaluation of blood flow in tissue byultrasound or MRI as well as invasively by methods such as biopsy withhistopathological examination and molecular marker analysis, endoscopy,isotope incorporation and gamma scintigraphy. All above methods ofmeasurement are used in conjunction with assessment of clinicalparameters for function of the affected tissue.

In specific embodiments, inflammation is measured as described in theExamples (e.g., CAM assays, or by measuring macrophage marker staining).In other embodiments, fibrosis is measured using a bleomycin mousemodel, or by measuring collagen synthesis.

A therapeutically effective amount of an agent of this invention in theform of a monoclonal antibody is typically an amount such that whenadministered in a physiologically tolerable composition is sufficient toachieve a plasma concentration of from about 0.01 microgram (ug) permilliliter (mL) to about 10 ug/mL, preferably from about 1 ug/mL toabout 5 ug/mL, and usually about 5 ug/mL. Stated differently, the dosagecan vary from about 0.5 mg/kg to about 100 mg/kg, preferably from about0.5 mg/kg to about 50 mg/kg (e.g., 0.5, 1, 2, 3, 5, 10, 12, 15, 20, 25,30, 35, 40, 45, 50 mg/kg) in one or more dose administrations daily, forone or several days. In one embodiment, the antibody dose is 0.5, 1, 5,10, 15, 20, or 25 mg/kg.

Where the agent is in the form of a fragment of a monoclonal antibody,the amount can readily be adjusted based on the mass of the fragmentrelative to the mass of the whole antibody. A preferred plasmaconcentration in molarity is from about 2 micromolar (uM) to about 5millimolar (mM) and preferably about 100 uM to 1 mM antibody antagonist.

A therapeutically effective amount of a denatured collagen antagonist ofthis invention in the form of a polypeptide, or small molecule, istypically an amount of polypeptide such that when administered in aphysiologically tolerable composition is sufficient to achieve a plasmaconcentration of from about 0.1 microgram (ug) per milliliter (mL) toabout 200 ug/mL, or from about 1 ug/mL to about 150 ug/mL. Based on apolypeptide having a mass of about 500 grams per mole, in oneembodiment, the plasma concentration in molarity is from about 2micromolar (uM) to about 5 millimolar (mM) or from 100 uM to 1 mMpolypeptide antagonist. In other embodiments, the doses of smallpeptides range from about 500 mg/Kg to about 1.0 g/kg (e.g., 500, 600,700, 750, 800, 900, 1000 mg/kg).

The agents of the invention can be administered parenterally byinjection or by gradual infusion over time. In other embodiments, agentsare administered intravenously, intraperitoneally, intramuscularly,subcutaneously, intracavity, transdermally, topically, intraocularly,orally, intranasally, and can be delivered by peristaltic means. In oneparticular embodiment, an agent of the invention is locally delivered toa site of inflammation or fibrosis.

In one embodiment, a therapeutic compositions containing an agent ofthis invention are administered in a unit dose, for example. The term“unit dose” when used in reference to a therapeutic composition of thepresent invention refers to physically discrete units suitable asunitary dosage for the subject, each unit containing a predeterminedquantity of active material calculated to produce the desiredtherapeutic effect in association with the required diluent; i.e.,carrier, or vehicle.

The compositions are administered in a manner compatible with the dosageformulation, and in a therapeutically effective amount. The quantity tobe administered and timing depends on the patient to be treated,capacity of the patient's system to utilize the active ingredient, anddegree of therapeutic effect desired. Precise amounts of activeingredient required to be administered depend on the judgement of thepractitioner and are peculiar to each individual. However, suitabledosage ranges for systemic application are disclosed herein and dependon the route of administration. Suitable regimes for administration alsoare variable, but are typified by an initial administration followed byrepeated doses at one or more hour intervals by a subsequent injectionor other administration. Alternatively, continuous intravenous infusionsufficient to maintain concentrations in the blood in the rangesspecified for in vivo therapies are contemplated.

Kits

The invention provides kits for altering the activity of one or moretypes of inflammatory cells. In one embodiment, the kit detects providesan agent that binds denatured collagen type I-IV (e.g., denaturedcollagen type-IV), wherein the agent alters the activity of one or moretypes of inflammatory cells, and instructions for use. Preferably, theagent alters inflammatory infiltration of a tissue or organ.

In other embodiments, the kit comprises a sterile container whichcontains the antagonist; such containers can be boxes, ampules, bottles,vials, tubes, bags, pouches, blister-packs, or other suitable containerform known in the art. Such containers can be made of plastic, glass,laminated paper, metal foil, or other materials suitable for holdingagents as described herein. Preferably, the kit further comprises anyone or more of reagents described or useful in the methods andcompositions herein.

In other embodiments, the instructions include at least one of thefollowing: methods for using the enclosed materials for the treatment orprevention of inflammation; methods for using the enclosed materials forthe treatment or prevention of fibrosis; precautions; warnings;indications; clinical or research studies; and/or references. Theinstructions may be printed directly on the container (when present), oras a label applied to the container, or as a separate sheet, pamphlet,card, or folder supplied in or with the container.

This invention is further illustrated by the following examples, whichshould not be construed as limiting. All documents mentioned herein areincorporated herein by reference.

EXAMPLES Example 1 CLK-Peptide Inhibited Eosinophillic Inflammatory CellInfiltration

The Chick Chorioallantoic Membrane (CAM) model is a well-established invivo model to examine a variety of complex biological processes, such asangiogenesis, tumor growth as well as inflammation. Investigatorsroutinely use the CAM assay to examine the effects of various compoundsand bio-implants on inflammation. In a first set of experiments, aninflammatory response was induced by physically separating the CAM fromthe shell membrane in the absence of cortisone acetate, and stimulatingthe CAM tissue with FGF-2 to induce a robust inflammatory response. TheCLK or control peptides were then applied topically to the CAMs. At theend of a three-day incubation period the CAM tissues were removed andanalyzed. As shown in FIG. 1A (Top left), untreated CAM tissuesexhibited minimal if any tissue thickening surrounding the centralfilter disc. In contrast, bFGF (FGF-2) potently induced a stronginflammatory response (Top right) as indicated by the robust thickeningof CAM, which begins to overlap and partially cover the central area ofthe filter disc (Arrows). Similar results are noted under controlpeptide treated conditions (Bottom left). Importantly, treatment withCLK-peptide (250 ug/day) dramatically reduced the overall levels ofinflammation (Bottom right) as compared to either bFGF-2 alone (Topright) or control peptide (Bottom left). At the end of a three-dayincubation period the CAM tissues were removed and analyzed. Resultingtissues were stained by hemotoxylin and eosin (H & E) and examinedhistologically. As shown in FIG. 1B (Top left), few eosinophillicinfiltrates were observed in the untreated CAM tissues (Arrow). Incontrast, FGF-2 potently induced a strong inflammatory response (Topright) as indicated by the robust infiltration of the eosinophillic(pink) infiltrates (arrows). These results showed that treatment withCLK-peptide dramatically reduced the overall levels of inflammatoryinfiltrates (Bottom left) as compared to either bFGF-2 alone (Top right)or control peptide (Bottom right).

To quantify the relative impact of the CLK-peptide on inflammation, thepercentage of the individual CAMs from two independent experiments(FIGS. 1C and D) that exhibited strong positive inflammation wasdetermined. Strong positive inflammation was scored as those CAMs wherethe CAM tissue was thickened and partially covered the central area ofthe filter disc. As shown in FIGS. 1C and D, the CLK peptide potentlyreduced the number of CAMs (percentage) exhibiting thickening(inflammation) as compared to either control peptide or bFGF treatedCAMs. These surprising findings indicate that the cryptic epitoperecognized by CLK-peptide likely regulates infiltration of eosinophillicinfiltrates. Moreover, these studies indicate that targeting a crypticcollagen epitope is useful for the treatment of diseases and disordersassociated with inflammation and fibrosis.

Example 2 Macrophages Adhere to the CLK/HU177 Cryptic Epitope

Macrophages represent one of many different inflammatory cell type thatare thought to contribute to inflammation and fibrosis. To determinewhether primary murine macrophages have the capacity to adhere and bindto denatured collagen, peritoneal macrophages were collected and seededon denatured collagen type-IV-coated plates. As shown in FIG. 2A (Leftpanel), macrophages attached to denatured collagen-IV. To morespecifically examine the ability of macrophages to interact with theCLK/HU177 cryptic site, cells were seeded on wells coated with thespecific CLK/HU177 epitope and allowed to attach. As shown in FIG. 2B(Right panel), macrophages not only attached, but also began to spreadon the CLK/HU177 cryptic epitope. These finding suggest that primarymacrophages have the ability to bind to CLK/HU177 cryptic site exposedwithin collagen type-IV.

The CLK/HU177 cryptic epitope regulates endothelial cell behavior invitro and angiogenesis in vivo, and thus provides one potential cellularmechanism that contributes to the ability of the CLK/HU177 epitope toregulate tumor progression (Cretu A., et al. Clin. Cancer. Res. 2007).Interestingly, a number of important studies have provided evidence thatbone marrow-derived cells, such as macrophages, are actively recruitedto sites of angiogenesis, tumor growth and metastasis and may playfunctional roles in regulating tumor progression (Pollard, J. W. Nat.Rev Immunol. 2009; Wycoff, J. B. Cancer Res. 2007; Bingle, L. J. Pathol.2002). Some studies have estimated that macrophage infiltration oftumors occurs in nearly 80% of cancers (Bingle, L. J. Pathol. 2002).Elevated levels of macrophage infiltration of malignant tumors oftencorrelates with poor prognosis (Torisu, H., Int. J. Cancer 2000; Prost.Lip. Med. 83: 320-328. 2007).

To gain access to sites of angiogenesis and tumor growth, macrophagesmust adhere to, invade and migrate through both basement membranes andthe interstitial matrix. Macrophages have been shown to be a majorsource of pro-angiogenic factors, such as VEGF and matrix alteringproteases such as MMP-9, thereby contributing to tumor progression(Murdoch, C., Nat. Rev. Cancer. 2008; Nakamura, T., Neoplasia. 2007).Studies have indicated that MMP-9 plays an important role in exposingcryptic collagen epitopes at sites of tissue invasion (Hangai. M., Am.J. Pathol. 2002; Gagne, P. J., Am. J. Pathol. 2005). Given thesefindings, coupled with the known role of macrophages in tissueremodeling, localized exposure of the CLK/HU177 cryptic epitope mayprovide a selectively expressed cryptic ECM ligand used by macrophagesto facilitate their infiltration into tumors.

While some studies have suggested that macrophages can help reduce tumorgrowth, many other studies have indicated macrophages may promote tumorprogression (Mytar, B., Anticancer Res. 2008; Ono, M. Cancer Sci. 2008;Lewis, C. E., Cancer Res. 2006). In fact, studies suggest that depletionof macrophages reduces angiogenesis, tumor growth, and metastasis incertain tumor types (Mytar, B., Anticancer Res. 2008; Ono, M. CancerSci. 2008; Lewis, C. E., Cancer Res. 2006). In addition, selectiveinhibition of M-CSF (Macrophage Colony Stimulating Factor) can inhibitpathological angiogenesis in vivo (Kubota, Y., J. Exp. Med.). Moreover,recent studies also suggest that macrophages may incorporate intoangiogenic vessels (Kim Am J Pathol. 2009).

Given these findings, the present inventors sought to determine whethermacrophages might utilize the CLK/HU177 cryptic collagen epitope toinfiltrate into malignant tumors. The findings suggest that macrophagesinteract with the CLK/HU177 cryptic epitope and that a function blockingpeptide directed to this cryptic site inhibits macrophage binding. Thesenovel results are consistent with the CLK/HU177 cryptic epitoperegulating tumor progression by promoting macrophage infiltration intomalignant tumors.

Example 3 Synthetic Function Blocking Peptide (CLK-Peptide) Directed tothe CLK/HU177 Cryptic Epitope Reduces Macrophage Adhesion

Given that the ability of macrophages to interact with damaged anddenatured collagen is likely to play a role in their ability to localizeto sites of tissue damage, a next set of experiments examined whetherthe synthetic peptide, which specifically binds to the CLK/HU177 crypticepitope, inhibited macrophage adhesion in vitro. Culture plates werecoated with the CLK/HU177 cryptic epitope as described above, andmacrophages were allowed to bind in the presence or absence of thefunction blocking CLKpeptide. As shown in FIG. 3A, macrophages readilyattached to the immobilized cryptic collagen epitope. In contrast,macrophage adhesion was reduced (FIG. 3B) in the presence of theCLK-peptide as compared to no treatment (FIG. 3A) or control (FIG. 3C).These studies indicate that specifically targeting the CLK/HU177 crypticepitope with a synthetic peptide inhibited macrophage adhesion to theCLK/HU177 cryptic site.

Example 4 Synthetic Function Blocking peptide (CLK-Peptide) Directed tothe CLK/HU177 Cryptic Epitope Inhibits Fibroblast Cell Adhesion toDenatured Collagen

Fibrosis involves the infiltration of activated fibroblasts, whichsecrete elevated levels of the collagen that forms fibrotic tissue. Todetermine whether the CLK-peptide might inhibit interactions offibroblasts with denatured collagen-IV in vitro, culture plates werecoated with denatured collagen type-IV, as described above, and ratfibroblasts were allowed to bind in the presence or absence of thefunction blocking CLK-peptide or a nonspecific control peptide. As shownin FIG. 4, fibroblasts readily attached to the immobilized denaturedcollagen. In contrast, fibroblast adhesion was dramatically inhibited inthe presence of the CLK-peptide. The control peptide had little if anyeffect on fibroblast adhesion. These studies indicate that specificallytargeting the CLK/HU177 cryptic epitope with a synthetic peptideinhibited interaction and infiltration of collagen secreting fibroblastinto areas of tissue damage.

Example 5 Fibroblast Interaction with Denatured Collagen-IV Results inEnhanced Collagen Production

During inflammation and fibrosis, tissue damage is thought to result inelevated levels of proteolytic enzymes, which can denature a variety offorms of collagen. Importantly, a pathological hallmark of fibrosis isthe increased expression and accumulation of matrix proteins, such ascollagen type-I and -IV by fibroblast and other inflammatory cell types,which largely replaces the normal tissue structure. To determine whetherthe expression of collagen type-I was altered in fibroblasts interactingwith normal intact collagen as compared to damaged or denatured collagentype-IV, equal numbers of rat fibroblast were resuspended in adhesionbuffer and allowed to interact with culture plates coated with eitherintact native or denatured collagen-IV for 24 hours. Conditioned mediumfrom each condition was then collected and the relative level ofcollagen type-I was examined by solid phase ELISA. As shown in FIG. 5,elevated levels of collagen type-I were detected in conditioned mediumfrom fibroblasts attached to denatured collagen type-IV as compared tonative collagen type-IV. These experiments suggest that fibroblastinteractions with a cryptic epitope exposed within collagen type-IV mayresult in enhanced expression of collagen type-I.

Example 6 CLK-Peptide Inhibited Fibroblast Cell Adhesion to DenaturedCollagen Type-I

The cryptic collagen epitope recognized by the CLK-peptide is expressedwithin collagen type-I as well as collagen type-IV. Therefore todetermine whether the CLK cryptic epitope may inhibit fibroblast celladhesion to denatured collagen type-I, cell adhesion in vitro wasexamined as described above. Briefly, culture plates were coated withdenatured collagen-I, and rat fibroblasts were allowed to bind in thepresence or absence of the function blocking CLK-peptide or non-specificcontrol peptide. As shown in FIG. 6, fibroblasts readily attached to theimmobilized denatured collagen type-1. In contrast, fibroblast adhesionwas dose dependently inhibited in the presence of the CLK-peptide. Thesestudies indicate that specifically targeting the CLK/HU177 crypticepitope with a synthetic peptide may inhibit fibroblast interactionswith collagen type-I as well as collagen type-IV.

Example 7 UVA Irradiation Exposed the HU177 Cryptic Collagen Epitope InVitro and in Explanted Murine Skin

It is well accepted that chronic solar irradiation to unprotected skinis a major risk factor for many forms of skin cancer including melanoma.Military personnel may be unavoidably subjected to prolonged high levelexposure to solar irradiation due to the unique nature of theenvironments encountered during military operations. In this regard, theidentification of pathological mechanisms that facilitate carcinogenesisas well as the development of novel strategies to prevent or reduceUV-induced skin damage, may lead to reductions in the incidence andprogression of melanoma. Recent studies suggest that even acute UVexposure can result in structural and biomechanical changes in thephysical properties of extracellular matrix (ECM) molecules, such ascollagen, which represents nearly 90% of the ECM protein in skinUV-mediated alterations in collagen structure may result from multiplemechanisms such as direct UV-induced oxidative damage from reactiveoxygen species (ROS) and secondary proteolytic damage from UV-inducedinflammatory cell infiltration. Collectively, these mechanisms andothers may result in the accumulation of altered collagen withinbasement membranes and within the interstitial stroma of UV-exposedskin. UV irradiation is also known to promote pathological alterationswithin the epidermal and dermal layers of the skin including epidermalhyperplasia, inflammatory cell infiltration, enhanced angiogenesis andmodulation of gene expression in resident cells such as fibroblasts,keratinocytes and melanocytes.

UV irradiation can lead to specific changes within the molecularstructure of collagen that are thought to contribute to photodamage inskin, such as altered molecular cross-linking, changes in thermalstability and degradation of protein structure. It was recently foundthat acute UVA irradiation, but surprisingly not UVB, at a dose as lowas 0.6 J/cm², may cause exposure of the HU177 cryptic collagen epitopein vitro and within full thickness explanted murine skin. Thesesurprising findings are of particular significance given that UVAwavebands represent most of the solar wavelengths that penetrate to theearth surface, as compared to UVB wavebands, which represent asignificantly lower proportion of solar irradiation, but which isthought to mediate much of the cellular and DNA damage associated withUV irradiation.

It has previously been shown that the HU177 cryptic collagen epitopeplays a role in angiogenesis and melanoma tumor growth (Cretu, 2007;Pollard, 2009). A humanized Mab termed D93 directed to the HU177 crypticsite is currently being evaluated in a phase 1 clinical trial. Studiessuggest no significant dose limiting toxicities in patients up to 25mg/kg and importantly, evidence of anti-tumor activity has beenobserved. Based on these findings and results described hereinsuggesting that a small peptide antagonist (CLK-peptide) of the HU177epitope sharply reduces macrophage cell adhesion to damaged collagen andmay reduce inflammatory cell infiltration in vivo, UV irradiation mayinduce an acute and early biomechanical change in collagen structure(HU177 epitope exposure) that may facilitate the invasion ofinflammatory cells through UVA-altered basement membranes andinterstitial matrix. This enhanced inflammation and associated stromalreaction may represent an early event that promotes the creation of amelanoma permissive microenvironment over time. Further, treatment withantagonists of the HU177 epitope, prior to or after exposure to UVirradiation, can likely prevent or reduce localized infiltration ofdamaging inflammatory cells and the subsequent establishment of melanomatumors within the skin.

Other Embodiments

From the foregoing description, it will be apparent that variations andmodifications may be made to the invention described herein to adopt itto various usages and conditions. Such embodiments are also within thescope of the following claims.

The recitation of a listing of elements in any definition of a variableherein includes definitions of that variable as any single element orcombination (or subcombination) of listed elements. The recitation of anembodiment herein includes that embodiment as any single embodiment orin combination with any other embodiments or portions thereof.

All patents and publications mentioned in this specification are hereinincorporated by reference to the same extent as if each independentpatent and publication was specifically and individually indicated to beincorporated by reference.

CITATIONS

The following documents are cited herein.

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1. A method of reducing fibrosis, inflammation, or inflammatory cellinfiltration of a site in a subject in need thereof, the methodcomprising administering to the subject a therapeutically effectiveamount of an agent that binds denatured collagen type I-IV, wherein theagent is selected from the group consisting of: proteins, peptides,antibodies, aptamers, oligopeptides and small molecule inhibitors. 2.The method of claim 1, wherein the agent reduces the infiltration of oneor more types of inflammatory cells selected from the group consistingof: monocytes, macrophages, neutrophils, and mast cells to a site insaid subject.
 3. (canceled)
 4. A method of preventing or reducingultraviolet radiation damage, ionizing radiation damage, or chemotherapydamage to a cell, tissue, or organ, the method comprising administeringto the subject a therapeutically effective amount of an agent that bindsdenatured collagen type I-IV, wherein the agent is selected from thegroup consisting of: proteins, peptides, antibodies, aptamers,oligopeptides and small molecule inhibitors.
 5. (canceled)
 6. The methodof claim 1, wherein the inflammatory cell is selected from the groupconsisting of: monocytes, macrophages, neutrophils, and mast cells. 7.The method of claim 1, wherein the agent reduces inflammatory cellinfiltration to a site.
 8. The method of claim 1, wherein the agentreduces adhesion to extracellular matrix or basement membrane.
 9. Themethod of claim 1, wherein the agent reduces fibroblast cell adhesion todenatured collagen type I-IV.
 10. The method of claim 4, wherein theagent is administered prior to, concurrent with, or subsequent to UVAradiation or ionizing radiation exposure or prior to chemotherapy. 11.The method of claim 1, wherein the site is the site of a bio-implant.12. The method of claim 1, wherein the agent is an antibody.
 13. Themethod of claim 11, wherein the antibody is a monoclonal antibody. 14.The method of claim 11, wherein the antibody is humanized.
 15. Themethod of claim 1, wherein the agent specifically binds to an epitope ofdenatured collagen type-IV.
 16. The method of claim 11, wherein theagent specifically binds to an epitope of anti-denatured collagentype-IV comprising GLGP (SEQ ID NO: 2), GLGPGP (SEQ ID NO: 3), orOGAKGLPGPOGPOGPY (SEQ ID NO: 1).
 17. The method of claim 16, wherein theagent is selected from the group consisting of: L-K-Q-N-G-G-N-F-S-L (SEQID NO: 4), L-G, S-L-K-Q-N-G-G-N-F-S-L (SEQ ID NO: 5),C-L-K-Q-N-G-G-N-F-S-L-G (SEQ ID NO: 6), S-L-K-Q-N-G-G-N-F-S-L-C (SEQ IDNO: 7) and K-G-G-C-L-K-Q-N-G-G-N-F-S-L-G-G-K (SEQ ID NO: 8).
 18. Themethod of claim 1, wherein the subject has a condition selected from thegroup consisting of pulmonary fibrosis, liver fibrosis, and kidneyfibrosis.
 19. The method of claim 1, wherein the inflammation isassociated with a tissue selected from the group consisting ofpulmonary, liver, brain or kidney tissue.
 20. The method of claim 1,wherein the inflammation and/or fibrosis is associated with a conditionselected from the group consisting of arthritis, arthrosclerosis,scleroderma, sarcoidosis, psoriasis, inflammatory eye diseases, ischemicand inflammatory cardiovascular diseases, and ischemic and inflammatorybowel diseases.
 21. A kit for use in reducing inflammatory cellinfiltration into a site comprising an agent that binds denaturedcollagen type I-IV, and instructions for use.
 22. A kit for use intreating or preventing fibrosis or inflammation in a subject, the kitcomprising an agent that binds denatured collagen type I-IV, andinstructions for use.